UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 10-Q
ýQUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended SeptemberJune 30, 2019
2020
¨TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from  ___ to ___.
Commission File No. 001-37392
Apollo Medical Holdings, Inc.
(Exact name of registrant as specified in its charter)
Delaware
95-4472349
(State or other jurisdiction
Other Jurisdiction
(I.R.S. Employer
of incorporation or organization)Incorporation)
95-4472349
(IRS Employer Identification No.)
Number)
1668 S. Garfield Avenue, 2nd Floor, Alhambra, California 91801
(Address of principal executive offices and zip code)
(626) 282-0288
(Registrant’s telephone number, including area code) 
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days:   ý Yes     ¨No
Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).   ý   Yes     ¨No
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.
Large accelerated filerAccelerated filer
Non-accelerated filerSmaller reporting company
Large accelerated filer ¨
Accelerated filer x
Non-accelerated filer ¨
Smaller reporting company ¨
Emerging growth company¨
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ¨
Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act):  ¨Yes   ý  No
Securities registered pursuant to Section 12(b) of the Act:
Title of Each ClassTrading SymbolName of Each Exchange on Which Registered
Common Stock, $0.001 par value per shareAMEHNasdaq Capital Market
As of November 4, 2019,August 3, 2020, there were 34,892,50653,513,655 shares of common stock of the registrant, $0.001 par value per share, issued and outstanding.




APOLLO MEDICAL HOLDINGS, INC.
INDEX TO FORM 10-Q FILING
TABLE OF CONTENTS
PAGE



2


Glossary

The following abbreviations or acronyms that may be used in this document shall have the adjacent meanings set forth below:
Accountable Health CareAccountable Health Care IPA, a Professional Medical Corporation
AHMCAHMC Healthcare Inc.
AIPBPAll-Inclusive Population-Based Payments
Alpha CareAlpha Care Medical Group, Inc.
AMGAMG, a Professional Medical Corporation
AMHApolloMed Hospitalists, a Medical Corporation
AMMApollo Medical Management, Inc.
AP-AMHAP-AMH Medical Corporation
APAACOAPA ACO, Inc.
APCAllied Pacific of California IPA
APC-LSMAAPC-LSMA Designated Shareholder Medical Corporation
Apollo Care ConnectApollo Care Connect, Inc.
BAHABay Area Hospitalist Associates
BrightBright Health Company of California, Inc.
CDSCConcourse Diagnostic Surgery Center, LLC
CQMCCritical Quality Management Corporation
CSICollege Street Investment LP, a California limited partnership
DMHCCalifornia Department of Managed Healthcare
DMGDiagnostic Medical Group
HSMSOHealth Source MSO Inc., a California corporation
ICCAHMC International Cancer Center, a Medical Corporation
IPAindependent practice association
LMALaSalle Medical Associates
MMGMaverick Medical Group, Inc.
MPPMedical Property Partners
NGACONext Generation Accountable Care Organization
NMMNetwork Medical Management, Inc.
PASCPacific Ambulatory Health Care, LLC
PMIOCPacific Medical Imaging and Oncology Center, Inc.
SCHCSouthern California Heart Centers
UCAPUniversal Care Acquisition Partners, LLC
UCIUniversal Care, Inc.
VIEVariable Interest Entity
3



INTRODUCTORY NOTE
Unless the context dictates otherwise, references in this Quarterly Report on Form 10-Q to the “Company,” “we,” “us,” “our,” and similar words are references to Apollo Medical Holdings, Inc., a Delaware corporation, and its consolidated subsidiaries and affiliated entities, as appropriate, including its consolidated variable interest entities (“VIEs”). and “ApolloMed” refers to Apollo Medical Holdings, Inc.
The Centers for Medicare & Medicaid Services (“CMS”) have not reviewed any statements contained in this Quarterly Report on Form 10-Q describing the participation of APA ACO, Inc. (“APAACO”) in the next generation accountable care organizationNext Generation Accountable Care Organization (“NGACO”) model.Model.
Trade names and trademarks of the Company and its subsidiaries referred to herein and their respective logos, are our property. This Quarterly Report on Form 10-Q may contain additional trade names and/or trademarks of other companies, which are the property of their respective owners. We do not intend our use or display of other companies’ trade names and/or trademarks, if any, to imply an endorsement or sponsorship of us by such companies, or any relationship with any of these companies.

NOTE ABOUT FORWARD-LOOKING STATEMENTS
        This Quarterly Report on Form 10-Q contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995, Section 27A of the Securities Act of 1933, as amended (the “Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”). All statements other than statements of historical fact are “forward-looking statements” for purposes of federal and state securities laws, including, but not limited to, statements about the Company's guidance for the year ending December 31, 2020, any statements about our business (including the impact of the 2019 Novel Coronavirus (COVID-19) pandemic on our business), financial condition, operating results, plans, objectives, expectations and intentions, any guidance on, or projections of, earnings, revenue or other financial items, such as our projected capitation from CMS for the year ending December 31, 2020 or otherwise, and our future liquidity, including cash flows and any payments under the $545.0 million loan we made to our VIE, AP-AMH; any statements of any plans, strategies and objectives of management for future operations such as the material opportunities that we believe exist for our Company; any statements concerning proposed services, developments, mergers or acquisitions; any statements regarding the outlook on our NGACO Model or strategic transactions; any statements regarding management’s view of future expectations and prospects for us; any statements about prospective adoption of new accounting standards or effects of changes in accounting standards; any statements regarding future economic conditions or performance; any statements of belief; any statements of assumptions underlying any of the foregoing; and other statements that are not historical facts. Forward-looking statements may be identified by the use of forward-looking terms such as “anticipate,” “could,” “can,” “may,” “might,” “potential,” “predict,” “should,” “estimate,” “expect,” “project,” “believe,” “think,” “plan,” “envision,” “intend,” “continue,” “target,” “seek,” “contemplate,” “budgeted,” “will,” “would,” and the negative of such terms, other variations on such terms or other similar or comparable words, phrases or terminology. These forward-looking statements present our estimates and assumptions only as of the date of this Quarterly Report on Form 10-Q and are subject to change.
        Forward-looking statements involve risks and uncertainties and are based on the current beliefs, expectations and certain assumptions of management. Some or all of such beliefs, expectations and assumptions may not materialize or may vary significantly from actual results. Such statements are qualified by important economic, competitive, governmental and technological factors that could cause our business, strategy, or actual results or events to differ materially from those in our forward-looking statements. Factors that might cause or contribute to such differences include, but are not limited to, those discussed in our Annual Report on Form 10-K, for the year ended December 31, 2019, filed with the SEC on March 16, 2020, including, the risk factors discussed under the heading “Risk Factors” in Part I, Item IA thereof. Although we believe that the expectations reflected in our forward-looking statements are reasonable, actual results could differ materially from those projected or assumed in any of our forward-looking statements. Our future financial condition and results of operations, as well as any forward-looking statements, are subject to change, and significant risks and uncertainties that could cause actual conditions, outcomes and results to differ materially from those indicated by such statements.

PART I FINANCIAL INFORMATION

ITEM 1. CONSOLIDATED FINANCIAL STATEMENTS - UNAUDITED
4

APOLLO MEDICAL HOLDINGS, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)
(UNAUDITED)
September 30,
2019
 December 31,
2018
June 30,
2020
December 31,
2019
   
Assets   Assets
   
Current assets   Current assets
Cash and cash equivalents$230,298,252
 $106,891,503
Cash and cash equivalents$152,441  $103,189  
Restricted cash20,150
 
Restricted cash—  75  
Investment in marketable securities1,154,480
 1,127,102
Investment in marketable securities117,656  116,539  
Receivables, net19,731,189
 7,127,217
Receivables, net17,588  11,004  
Receivables, net – related parties37,708,178
 49,328,739
Receivables, net – related parties59,328  48,136  
Other receivables15,527,520
 1,003,133
Other receivables15,919  16,885  
Prepaid expenses and other current assets10,495,938
 7,385,098
Prepaid expenses and other current assets11,188  10,315  
Loans receivable - related parties6,425,000
 
Loans receivableLoans receivable6,425  6,425  
Loans receivable – related partiesLoans receivable – related parties—  16,500  
   
Total current assets321,360,707
 172,862,792
Total current assets380,545  329,068  
   
Noncurrent assets   Noncurrent assets
Restricted cashRestricted cash746  746  
Land, property and equipment, net12,427,107
 12,721,082
Land, property and equipment, net11,485  12,130  
Intangible assets, net114,166,305
 86,875,883
Intangible assets, net94,790  103,012  
Goodwill237,134,772
 185,805,880
Goodwill239,053  238,505  
Loans receivable – related parties, net of current portion12,500,000
 17,500,000
Investment in other entities – equity method35,840,105
 34,876,980
Investment in other entities – equity method26,817  28,427  
Investment in a privately held entity that does not report net asset value per share896,000
 405,000
Restricted cash746,104
 745,470
Right-of-use assets13,540,129
 
Investments in privately held entitiesInvestments in privately held entities37,075  896  
Operating lease right-of-use assetsOperating lease right-of-use assets20,219  14,248  
Other assets1,633,153
 1,205,962
Other assets22,487  1,681  
   
Total noncurrent assets428,883,675
 340,136,257
Total noncurrent assets452,672  399,645  
   
Total assets$750,244,382
 $512,999,049
Total assets$833,217  $728,713  
Liabilities, Mezzanine Equity and Stockholders’ Equity   
Liabilities, mezzanine equity and stockholders’ equityLiabilities, mezzanine equity and stockholders’ equity
   
Current liabilities   Current liabilities
   
Accounts payable and accrued expenses$35,539,917
 $25,075,489
Accounts payable and accrued expenses$24,788  $27,279  
Fiduciary accounts payable1,734,142
 1,538,598
Fiduciary accounts payable1,853  2,027  
Medical liabilities53,819,647
 33,641,701
Medical liabilities70,273  58,725  
Income taxes payable1,392,492
 11,621,861
Income taxes payable42,210  4,529  
Bank loan
 40,257
Dividend payable271,279
 
Dividend payable431  271  
Finance lease liabilities101,741
 101,741
Finance lease liabilities102  102  
Operating lease liabilitiesOperating lease liabilities3,350  2,990  
4
5

APOLLO MEDICAL HOLDINGS, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS (Continued)
(UNAUDITED)

June 30,
2020
December 31,
2019
September 30,
2019
 December 31,
2018
   
Operating lease liabilities2,836,010
 
Current portion of long term debt9,500,000
  
Current portion of long-term debtCurrent portion of long-term debt9,500  9,500  
Total current liabilities105,195,228
 72,019,647
Total current liabilities152,507  105,423  
   
Noncurrent liabilities   Noncurrent liabilities
Lines of credit – related party
 13,000,000
Deferred tax liability30,199,423
 19,615,935
Deferred tax liability13,654  18,269  
Liability for unissued equity shares1,185,025
 1,185,025
Finance lease liabilities441,241
 517,261
Operating lease liabilities10,670,364
 
Finance lease liabilities, net of current portionFinance lease liabilities, net of current portion355  416  
Operating lease liabilities, net of current portionOperating lease liabilities, net of current portion17,418  11,373  
Long-term debt, net of current portion and deferred financing costs234,149,063
 
Long-term debt, net of current portion and deferred financing costs230,455  232,172  
   
Total noncurrent liabilities276,645,116
 34,318,221
Total noncurrent liabilities261,882  262,230  
   
Total liabilities381,840,344
 106,337,868
Total liabilities414,389  367,653  
   
Commitments and Contingencies (Note 11)

 

Commitments and contingencies (Note 11)Commitments and contingencies (Note 11)


   
Mezzanine equity   Mezzanine equity
Noncontrolling interest in Allied Physicians of California, a Professional Medical Corporation (“APC”)176,230,074
 225,117,029
Noncontrolling interest in Allied Physicians of California, a Professional Medical CorporationNoncontrolling interest in Allied Physicians of California, a Professional Medical Corporation210,980  168,725  
   
Stockholders’ equity   Stockholders’ equity
Series A Preferred stock, $0.001 par value; 5,000,000 shares authorized (inclusive of all preferred stock, including Series B Preferred stock); 1,111,111 issued and zero outstanding at September 30, 2019 and December 31, 2018, respectively
 
Series B Preferred stock, $0.001 par value; 5,000,000 shares authorized (inclusive of all preferred stock, including Series A Preferred stock); 555,555 issued and zero outstanding at September 30, 2019 and December 31, 2018, respectively
 
Common stock, $0.001 par value; 100,000,000 shares authorized, 34,822,933 and 34,578,040 shares outstanding, excluding 16,959,069 and 1,850,603 treasury shares, at September 30, 2019 and December 31, 2018, respectively34,823
 34,578
Series A Preferred stock, $0.001 par value per share; 5,000,000 shares authorized (inclusive of all preferred stock, including Series B Preferred stock); 1,111,111 issued and 0 outstandingSeries A Preferred stock, $0.001 par value per share; 5,000,000 shares authorized (inclusive of all preferred stock, including Series B Preferred stock); 1,111,111 issued and 0 outstanding—  —  
Series B Preferred stock, $0.001 par value per share; 5,000,000 shares authorized (inclusive of all preferred stock, including Series A Preferred stock); 555,555 issued and 0 outstandingSeries B Preferred stock, $0.001 par value per share; 5,000,000 shares authorized (inclusive of all preferred stock, including Series A Preferred stock); 555,555 issued and 0 outstanding—  —  
Common stock, $0.001 par value per share; 100,000,000 shares authorized, 36,309,513 and 35,908,057 shares outstanding, excluding 17,475,707 and 17,458,810 treasury shares, at June 30, 2020, and December 31, 2019, respectivelyCommon stock, $0.001 par value per share; 100,000,000 shares authorized, 36,309,513 and 35,908,057 shares outstanding, excluding 17,475,707 and 17,458,810 treasury shares, at June 30, 2020, and December 31, 2019, respectively36  36  
Additional paid-in capital165,521,888
 162,723,051
Additional paid-in capital163,986  159,608  
Retained earnings25,177,257
 17,788,203
Retained earnings43,001  31,905  
190,733,968
 180,545,832
207,023  191,549  
   
Noncontrolling interest1,439,996
 998,320
Noncontrolling interest825  786  
   
Total stockholders’ equity192,173,964
 181,544,152
Total stockholders’ equity207,848  192,335  
   
Total liabilities, mezzanine equity and stockholders’ equity$750,244,382
 $512,999,049
Total liabilities, mezzanine equity and stockholders’ equity$833,217  $728,713  
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

6

APOLLO MEDICAL HOLDINGS, INC.
CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(IN THOUSANDS, EXCEPT PER SHARE AMOUNTS)
(UNAUDITED)
Three Months Ended
September 30,
 Nine Months Ended
September 30,
Three Months Ended
June 30,
Six Months Ended June 30,
2019 2018 2019 20182020201920202019
Revenue       Revenue
Capitation, net$130,807,706
 $90,612,720
 $305,548,176
 $266,834,186
Capitation, net$140,949  $103,224  $281,370  $174,740  
Risk pool settlements and incentives11,355,069
 57,788,932
 32,639,960
 89,641,885
Risk pool settlements and incentives12,003  11,191  23,239  21,285  
Management fee income8,517,586
 12,851,178
 27,866,805
 37,297,358
Management fee income8,690  10,353  17,505  19,349  
Fee-for-service, net4,099,660
 4,723,809
 12,058,762
 15,524,149
Fee-for-service, net2,270  3,878  5,697  7,959  
Other income1,280,203
 752,642
 3,753,258
 4,021,480
Other income1,257  1,404  2,463  2,473  
       
Total revenue156,060,224
 166,729,281
 381,866,961
 413,319,058
Total revenue165,169  130,050  330,274  225,806  
       
Operating expenses       Operating expenses
Cost of services131,129,813
 96,268,804
 315,925,388
 280,589,061
Cost of services136,079  101,363  280,283  184,795  
General and administrative expenses7,949,814
 9,040,336
 30,031,329
 31,481,810
General and administrative expenses11,556  11,818  23,390  22,081  
Depreciation and amortization4,920,429
 4,843,037
 13,792,581
 14,819,627
Depreciation and amortization4,628  4,455  9,330  8,872  
Provision for doubtful accounts
 
 (1,363,415) 
Provision for doubtful accounts—  (2,314) —  (1,363) 
Impairment of intangibles1,994,000
 
 1,994,000
 
       
Total expenses145,994,056
 110,152,177
 360,379,883
 326,890,498
Total expenses152,263  115,322  313,003  214,385  
       
Income from operations10,066,168
 56,577,104
 21,487,078
 86,428,560
Income from operations12,906  14,728  17,271  11,421  
       
Other income (expense)       Other income (expense)
Income (loss) from equity method investments2,053,730
 (4,215,056) 1,161,791
 (2,573,219)Income (loss) from equity method investments834  (42) 2,888  (892) 
Gain on sale of equity method investmentGain on sale of equity method investment99,647  —  99,647  —  
Interest expense(827,905) (178,318) (1,349,933) (374,002)Interest expense(2,673) (311) (5,541) (522) 
Interest income508,856
 418,449
 1,305,528
 1,180,990
Interest income863  474  1,792  797  
Other income2,620,485
 609,203
 2,831,830
 884,948
Other income1,282  24  1,384  211  
       
Total other income (expense), net4,355,166
 (3,365,722) 3,949,216
 (881,283)Total other income (expense), net99,953  145  100,170  (406) 
       
Income before provision for income taxes14,421,334
 53,211,382
 25,436,294
 85,547,277
Income before provision for income taxes112,859  14,873  117,441  11,015  
       
Provision for income taxes3,682,472
 14,585,942
 6,483,630
 23,338,589
Provision for income taxes31,858  4,209  33,453  2,801  
       
Net income
10,738,862
 38,625,440
 18,952,664
 62,208,688
Net income
81,001  10,664  83,988  8,214  
       
Net income attributable to noncontrolling interests7,034,688
 29,519,043
 11,563,610
 48,277,734
Net income attributable to noncontrolling interests73,957  7,119  72,892  4,529  
       
Net income attributable to Apollo Medical Holdings, Inc.$3,704,174
 $9,106,397
 $7,389,054
 $13,930,954
Net income attributable to Apollo Medical Holdings, Inc.$7,044  $3,545  $11,096  $3,685  
       
Earnings per share – basic$0.11
 $0.28
 $0.21
 $0.43
Earnings per share – basic$0.20  $0.10  $0.31  $0.11  
       
Earnings per share – diluted$0.10
 $0.24
 $0.20
 $0.37
Earnings per share – diluted$0.19  $0.09  $0.30  $0.10  
       
Weighted average shares of common stock outstanding – basic34,643,754
 32,917,007
 34,555,124
 32,672,793
       
Weighted average shares of common stock outstanding – diluted37,792,266
 38,387,700
 37,816,698
 38,010,838
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

7

APOLLO MEDICAL HOLDINGS, INC.
CONDENSED CONSOLIDATED STATEMENTS OF MEZZANINE AND SHAREHOLDERS’STOCKHOLDERS’ EQUITY
(IN THOUSANDS, EXCEPT SHARE DATA)
(UNAUDITED)
Mezzanine
Equity –
Noncontrolling
Interest in APC
Retained
Earnings
Common Stock Outstanding
Additional
Paid-in Capital
Noncontrolling
Interest
Shareholders’
Equity
SharesAmount
Balance at January 1, 2020$168,725  35,908,057  $36  $159,608  $31,905  $786  $192,335  
Net (loss) income(1,161) —  —  —  4,052  95  4,147  
Purchase of treasury shares—  (16,897) —  (301) —  —  (301) 
Purchase of noncontrolling interest(125) —  —  —  —  —  —  
Shares issued for exercise of options and warrants—  151,601  —  722  —  —  722  
Share-based compensation—  —  —  1,058  —  —  1,058  
Dividends(10,000) —  —  —  —  —  —  
Balance at March 31, 2020$157,439  36,042,761  $36  $161,087  $35,957  $881  $197,961  
Net income73,667  —  —  —  7,044  291  7,335  
Purchase of noncontrolling interest(126) —  —  —  —  —  —  
Shares issued for vesting of restricted stock awards—  24,453  —  —  —  —  —  
Shares issued for exercise of options and warrants—  242,299  —  2,283  —  —  2,283  
Share-based compensation—  —  —  852  —  —  852  
Cancellation of restricted stock awards—  —  —  (236) —  —  (236) 
Dividends(20,000) —  —  —  —  (347) (347) 
Balance at June 30, 2020$210,980  36,309,513  $36  $163,986  $43,001  $825  $207,848  
 
Mezzanine
Equity –
Noncontrolling
Interest in APC
            
 Noncontrolling Interest Common Stock Outstanding 
Additional
Paid-in Capital
 
Retained
Earnings
 
Noncontrolling
Interest
 
Shareholders'
Equity
  Shares Amount    
Balance January 1, 2019$225,117,029
 34,578,040
 $34,578
 $162,723,051
 $17,788,203
 $998,320
 $181,544,152
Net income(3,000,021) 
 
 
 139,664
 410,228
 549,892
Purchase of treasury shares(40,000) (93,451) (93) 93
 
 
 
Shares issued for exercise of options and warrants155,000
 17,516
 17
 139,957
 
 
 139,974
Share-based compensation202,382
 1,599
 2
 142,750
 
 
 142,752
Dividends(10,000,000) 
 
 
 
 
 
Balance at March 31, 2019212,434,390
 34,503,704
 34,504
 163,005,851
 17,927,867
 1,408,548
 182,376,770
Net income6,895,740
 
 
 
 3,545,216
 222,975
 3,768,191
Shares issued for exercise of options and warrants50,000
 135,108
 135
 757,993
 
 
 758,128
Share-based compensation202,382
 
 
 127,999
 
 
 127,999
Dividends
 
 
 
 
 (941,588) (941,588)
Balance at June 30, 2019$219,582,512
 34,638,812
 $34,639
 $163,891,843
 $21,473,083
 $689,935
 $186,089,500
Net income6,284,627
 
 
 
 3,704,174
 750,061
 4,454,235
Shares issued for exercise of options and warrants
 184,121
 184
 1,502,044
 
 
 1,502,228
Share-based compensation202,382
 
 
 128,001
 
 
 128,001
Stock subscription549,998
 
 
 
 
 
 
Stock issued in connection with acquisition of a business414,250
 
 
 
 
 
 
Costs related to issuance of preferred shares(803,695) 
 
 
 
 
 
Dividends(50,000,000) 
 
 
 
 
 
Balance at September 30, 2019$176,230,074
 34,822,933
 $34,823
 $165,521,888
 $25,177,257
 $1,439,996
 $192,173,964

Mezzanine
Equity –
Noncontrolling
Interest in APC
Retained
Earnings
Mezzanine
Equity –
Noncontrolling
Interest in APC
            Common Stock Outstanding
Additional
Paid-in Capital
Noncontrolling
Interest
Shareholders’
Equity
Noncontrolling Interest Common Stock Outstanding 
Additional
Paid-in Capital
 
Retained
Earnings
 
Noncontrolling
Interest
 
Shareholders'
Equity
SharesAmount
 Shares Amount 
Balance January 1, 2018$172,129,744
 32,304,876
 $32,305
 $158,181,192
 $1,734,531
 $4,235,398
 $164,183,426
ASC 606 Adoption7,351,434
       1,002,468
   1,002,468
Balance at January 1, 2019Balance at January 1, 2019$225,117  34,578,040  $35  $162,723  $17,788  $998  $181,544  
Net (loss) incomeNet (loss) income(3,000) —  —  —  140  410  550  
Purchase of treasury sharesPurchase of treasury shares(40) (93,451) —  —  —  —  —  
Shares issued for exercise of options and warrantsShares issued for exercise of options and warrants155  17,516  —  140  —  —  140  
Share-based compensationShare-based compensation202  1,599  —  143  —  —  143  
DividendsDividends(10,000) —  —  —  —  —  —  
Balance at March 31, 2019Balance at March 31, 2019$212,434  34,503,704  $35  $163,006  $17,928  $1,408  $182,377  
Net income12,970,752
 
 $
 $
 2,160,455
 586,448
 2,746,903
Net income6,896  —  —  $—  3,545  223  3,768  
Shares issued for exercise of options and warrants
 309,826
 310
 1,923,474
 
 
 1,923,784
Shares issued for exercise of options and warrants50  135,108  —  $758  —  —  758  
Share-based compensation202,382
 37,593
 38
 631,524
 
 
 631,562
Share-based compensation203  —  —  $128  —  —  128  
Dividends(2,000,000) 
 
 
 
 
 
Dividends—  —  —  $—  —  (942) (942) 
Balance at March 31, 2018190,654,312
 32,652,295
 32,653
 160,736,190
 4,897,454
 4,821,846
 170,488,143
Net income4,857,625
 
 
 
 2,664,102
 343,866
 3,007,968
Purchase price adjustment from merger
 
 
 868,000
 
 
 868,000
Shares issued for exercise of options and warrants200,000
 188,875
 188
 423,357
 
 
 423,545
Share-based compensation202,382
 
 
 
 
 
 
Noncontrolling interest capital charge
 
 
 
 
 27,500
 27,500
Balance at June 30, 2018195,914,319
 32,841,170
 32,841
 162,027,547
 7,561,556
 5,193,212
 174,815,156
Net income29,030,555
 
 
 
 9,106,397
 488,488
 9,594,885
Shares issued for exercise of options and warrants
 184,019
 184
 1,226,532
 
 
 1,226,716
Share-based compensation202,383
 
 
 
 
 
 
Acquisition of additional shares in consolidated equity
 
 
 (443,384)   443,184
 (200)
Purchase of treasury shares
 
 
 
 432,112
 
 432,112
Dividends
 
 
 
 
 (942,000) (942,000)
Balance at September 30, 2018$225,147,257
 33,025,189
 $33,025
 $162,810,695
 $17,100,065
 $5,182,884
 $185,126,669
Balance at June 30, 2019Balance at June 30, 2019$219,583  34,638,812  $35  $163,892  $21,473  $689  $186,089  
             
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

8

APOLLO MEDICAL HOLDINGS, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(IN THOUSANDS)
(UNAUDITED)
Six Months Ended
June 30,
20202019
Cash flows from operating activities
Net income$83,988  $8,214  
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Depreciation and amortization9,330  8,872  
Amortization of debt issuance costs658  —  
Provision for doubtful accounts—  (1,363) 
Share-based compensation1,910  676  
Unrealized loss (gain) from investment in equity securities25  (15) 
(Income) loss from equity method investments(2,888) 892  
Gain on sale of equity method investments(99,647) —  
Deferred tax(4,473) (549) 
Changes in operating assets and liabilities, net of business combinations:
Receivables, net(6,284) 588  
Receivables, net – related parties(11,191) (12,665) 
Other receivables966  (11,897) 
Prepaid expenses and other current assets(873) (2,740) 
Right-of-use assets1,680  1,098  
Other assets(5,095) (243) 
Accounts payable and accrued expenses(3,043) 3,340  
Fiduciary accounts payable(174) 260  
Medical liabilities11,252  (3,819) 
Income taxes payable37,681  (11,622) 
Operating lease liabilities(1,247) (1,044) 
Net cash provided by (used in) operating activities12,575  (22,017) 
Cash flows from investing activities
Payments for business acquisition, net of cash acquired—  (41,518) 
Proceeds from repayment of loans receivable – related parties16,500  —  
Advances on loans receivable—  (6,425) 
Purchases of marketable securities(1,142) (8) 
Purchases of investment – equity method(500) (2,158) 
Proceeds from sale of equity method investment52,743  —  
Purchases of property and equipment(451) (378) 
Dividend received—  240  
Net cash provided by (used in) investing activities67,150  (50,247) 
Cash flows from financing activities
Repayment of bank loan and lines of credit—  (8,040) 
Dividends paid(30,187) (10,942) 
Repayment of term loan(2,375) —  
9

 Nine Months Ended
September 30,
 2019 2018
Cash flows from operating activities   
Net income$18,952,664
 $62,208,688
Adjustments to reconcile net income to net cash provided by operating activities:   
Depreciation and amortization13,792,581
 14,819,627
Impairment of intangible1,994,000
 
Loss on disposal of property and equipment
 41,782
Provision for doubtful accounts(1,363,415) 
Share-based compensation1,005,898
 1,238,708
Gain on loan assumption(2,250,000) 
Unrealized (gain) loss from investment in equity securities(6,283) 10,218
(Income) loss from equity method investments(1,161,791) 2,573,219
Deferred tax(185,699) 7,135,408
Changes in operating assets and liabilities, net of business combinations:   
Receivable, net1,905,076
 4,484,115
Receivable, net – related parties5,864,052
 (43,360,966)
Other receivables(13,719,229) 
Prepaid expenses and other current assets(2,913,570) (80,618)
Right-of-use assets1,877,353
 
Other assets(524,689) (26,931)
Accounts payable and accrued expenses4,868,437
 31,701,367
Dividends payable
 
Incentives payable
 (16,500,000)
Fiduciary accounts payable195,544
 
Medical liabilities(6,226,426) (30,466,895)
Income taxes payable(10,229,369) (1,912,842)
Operating lease liabilities(1,790,313) 
Net cash provided by operating activities10,084,821
 31,864,880
    
Cash flows from investing activities   
Payments for business acquisitions, net of cash acquired(49,402,514) 
Advances on loans receivable(7,425,000) (2,500,000)
Purchases of marketable securities(21,095) (9,013)
Purchases of investment - equity method(2,949,000) (16,673,840)
Purchases of a privately held entity that does not report net asset value per share
 (405,000)
Purchases of property and equipment(806,590) (867,732)
Dividend received240,000
 207,410
Net cash used in investing activities(60,364,199) (20,248,175)
    
Cash flows from financing activities   
Repayment of bank loan and lines of credit(52,640,257) (375,485)
Dividends paid(60,670,309) (16,725,799)

Change in noncontrolling interest capital
 27,300
Payment of capital lease obligations(76,020) (73,775)
Proceeds from the exercise of stock options and warrants2,400,330
 3,574,046
Repurchase of shares(40,000) 
Borrowings on line of credit and long-term debt289,600,000
 8,000,000
Proceeds from common stock offering754,998
 200,000
Cost of debt and equity issuance costs(5,621,831) 
Net cash provided by (used in) financing activities173,706,911
 (5,373,713)
    
Net increase in cash, cash equivalents and restricted cash123,427,533
 6,242,992
    
Cash, cash equivalents and restricted cash, beginning of period107,636,973
 118,500,095
    
Cash, cash equivalents and restricted cash, end of period$231,064,506
 $124,743,087
    
Supplementary disclosures of cash flow information:   
Cash paid for income taxes$17,900,000
 $18,032,590
Cash paid for interest999,582
 287,332
    
Supplemental disclosures of non-cash investing and financing activities   
Cashless exercise of stock options$
 $47
Deferred tax liability adjustment to goodwill$11,539,600
 $1,110,456
Dividend declared included in dividend payable$271,279
 $
APC stock issued in exchange for AMG$414,250
 $
Refer to Note 16 for supplemental cash flow information related to the adoption of ASC 842. 

APOLLO MEDICAL HOLDINGS, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(UNAUDITED)
Payment of finance lease obligations(61) (50) 
Proceeds from the exercise of stock options and warrants2,863  898  
Repurchase of shares(788) (40) 
Borrowings on line of credit—  39,600  
Proceeds from common stock offering—  205  
Net cash (used in) provided by financing activities(30,548) 21,631  
Net increase (decrease) in cash, cash equivalents and restricted cash49,177  (50,633) 
Cash, cash equivalents and restricted cash, beginning of period104,010  107,637  
Cash, cash equivalents and restricted cash, end of period$153,187  $57,004  
Supplementary disclosures of cash flow information:
Cash paid for income taxes$—  $16,700  
Cash paid for interest2,623  439  
Supplemental disclosures of non-cash investing and financing activities
Dividend declared included in dividend payable$160  $—  
Deferred tax liability adjustment to goodwill—  8,355  
Preferred shares received from sale of equity method investment36,179  —  
The following table provides a reconciliation of cash, cash equivalents, and restricted cash reported within the condensed consolidated balance sheets that sum to the total amounts of cash, cash equivalents, and restricted cash shown in the condensed consolidated statements of cash flows.flows (in thousands):
Nine Months Ended
September 30,
June 30,
2019 201820202019
Cash and cash equivalents$230,298,252
 $119,779,499
Cash and cash equivalents$152,441  $52,726  
Restricted cash – short-term - distributions to former NMM shareholders20,150
 4,218,176
Restricted cash – letters of credit746,104
 745,412
Restricted cash – non-currentRestricted cash – non-current746  4,278  
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows$231,064,506
 $124,743,087
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows$153,187  $57,004  
The accompanying notes are an integral part of these unaudited condensed consolidated financial statements.

10

APOLLO MEDICAL HOLDINGS, INC.
NOTES TO CONDENSED CONSOLIDATED FINANCIAL STATEMENTS
(UNAUDITED)
1.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. 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 providingworking to provide coordinated, outcomes-basedoutcome-based medical care in a cost-effective manner and servingto patients in California, the majority of whom are covered by private or public insurance provided throughsuch as Medicare, Medicaid and health maintenance organizationsorganization (“HMOs”HMO”). A small plans, with a portion of the Company’s revenue is generatedcoming 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,Network Medical Management, Inc. (“NMM”), Apollo Medical Management, Inc. (“AMM”), APA ACO, Inc. ("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 primarily include primarily billing, collection, accounting, administrative,administration, quality assurance, marketing, compliance, and education. Following a business combination, NMM became a wholly-owned subsidiary of ApolloMed in December 2017.
Allied Physicians of California IPA, a Professional Medical Corporation d.b.a. Allied Pacific of California IPA (“APC”) was incorporated on August 17,in 1992, for the purpose of arranging health carehealthcare services as an IPA. APC has contracts with various HMOs and other licensed health carehealthcare 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 carehealthcare 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 carehealthcare 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.
OnIn 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”("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.
OnAP-AMH Medical Corporation (“AP-AMH”) was formed in May 2019, as a designated shareholder professional corporation. Dr. Thomas Lam, a shareholder, and the Chief Executive Officer and Chief Financial Officer of APC and Co-Chief Executive Officer of ApolloMed, is the sole shareholder of AP-AMH. ApolloMed makes all the decisions on behalf of AP-AMH and funds and receives all the distributions from its operations. ApolloMed has the rights to receive benefits from the operations of AP-AMH and has the option, but not the obligation, to cover losses. Therefore, AP-AMH is controlled and consolidated by ApolloMed as the primary beneficiary of this VIE.
In September 11, 2019, ApolloMed completed athe following series of agreementstransactions with two of its affiliates, AP-AMH and APC;
1.ApolloMed loaned AP-AMH $545.0 million pursuant to a 10-year secured loan agreement (the “AP-AMH Loan”). The loan bears interest at a rate of 10% per annum simple interest, is not prepayable (except in certain limited circumstances), requires quarterly payments of interest only in arrears, and is secured by a first priority security interest in all of AP-AMHs assets, including the shares of APC Series A Preferred Stock purchased by AP-AMH, as follows;
1.The Company loaned AP-AMH $545.0 million pursuant to a ten-year secured loan agreement. The loan bears interest at a rate of 10% per annum simple interest, is not prepayable (except in certain limited circumstances), requires quarterly payments of interest only in arrears, and is secured by a first priority security interest in all of AP-AMH's assets, including the shares of APC Series A Preferred Stock to be purchased by AP-AMH.described below. To the extent that AP-AMH is unable to make any interest payment when due because it has received dividends on the APC Series A Preferred Stock insufficient to pay in full such interest payment, then the outstanding principal amount of the loan will be increased by the amount of any such accrued but unpaid interest, and any such increased principal amounts will bear interest at the rate of 10.75% per annum simple interest.

2.AP-AMH purchased 1,000,000 shares of APC Series A Preferred Stock for aggregate consideration of $545.0 million in a private placement. Under the terms of the APC Certificate of Determination of Preferences of Series A Preferred Stock (the "Certificate of Determination"), AP-AMH is entitled to receive preferential, cumulative dividends that accrue on a daily basis and that are equal to the sum of (i) APC's net income from Healthcare Services (as defined in the Certificate of Determination), plus (ii) any dividends received by APC from certain of APC's affiliated entities, less (iii) any Retained Amounts (as defined in the Certificate of Determination).
3.APC purchased 15,015,015 shares of the Company's common stock for total consideration of $300.0 million in private placement. In connection therewith, the Company granted APC certain registration rights with respect to the Company's common stock that APC purchased, and APC agreed that APC votes in excess of 9.99% of the Company's then outstanding shares will be voted by proxy given to the Company's management, and that those proxy holders will cast the excess votes in the same proportion as all other votes cast on any specific proposal coming before the Company's stockholders.
4.The Company licensed to AP-AMH the right to use certain tradenames for certain specified purposes for a fee equal to a percentage of the aggregate gross revenues of AP-AMH. The license fee is payable out of any Series A Preferred Stock dividends received by AP-AMH from APC.
5.Through its subsidiary, NMM, the Company agreed to provide certain administrative services to AP-AMH for a fee equal to a percentage of the aggregate gross revenues of AP-AMH. The administrative fee also is payable out of any APC Series A Preferred Stock dividends received by AP-AMH from APC.
As of a result of the transaction, loan will be increased by the amount of any such accrued but unpaid interest, and any such increased principal amounts will bear interest at the rate of 10.75% per annum simple interest.
2.AP-AMH purchased 1,000,000 shares of APC Series A Preferred Stock for aggregate consideration of $545.0 million in a private placement. Under the terms of the APC Certificate of Determination of Preferences of Series A Preferred
11

Stock (the “Certificate of Determination”), AP-AMH is entitled to receive preferential, cumulative dividends that accrue on a daily basis and that are equal to the sum of (i) APC’s net income from healthcare services (as defined in the Certificate of Determination), plus (ii) any dividends received by APC from certain of APC’s affiliated entities, less (iii) any Retained Amounts (as defined in the Certificate of Determination).
3.APC purchased 15,015,015 shares of ApolloMed’s common stock for total consideration of $300.0 million in private placement. In connection therewith, ApolloMed granted APC certain registration rights with respect to ApolloMed’s common stock that APC purchased, and APC agreed that APC votes in excess of 9.99% of ApolloMed’s then outstanding shares will be voted by proxy given to ApolloMed’s management, and that those proxy holders will cast the excess votes in the same proportion as all other votes cast on any specific proposal coming before ApolloMed’s stockholders.
4.ApolloMed licensed to AP-AMH the right to use certain trade names for certain specified purposes for a fee equal to a percentage of the aggregate gross revenues of AP-AMH. The license fee is payable out of any Series A Preferred Stock dividends received by AP-AMH from APC.
5.Through its subsidiary, NMM, the Company agreed to provide certain administrative services to AP-AMH for a fee equal to a percentage of the aggregate gross revenues of AP-AMH. The administrative fee also is payable out of any APC Series A Preferred Stock dividends received by AP-AMH from APC.
APC's ownership in ApolloMed increased to 32.54%was 32.28% at SeptemberJune 30, 2019 from 4.82%2020 and 32.50% at December 31, 2018.2019.
Concourse Diagnostic Surgery Center, LLC (“CDSC”) was formed onin March 25, 2010 in the state of California. CDSC is an ambulatory surgery center in City of Industry, California. ItsCalifornia organized by a group of highly qualified physicians, which utilizes some of the most advanced equipment in the eastern part of Los Angeles County and the San Gabriel Valley. The facility is Medicare Certifiedcertified and accredited by the Accreditation Association for Ambulatory Healthcare, Inc. During 2011,As of June 30, 2020, APC invested $0.6 million forowned 45.01% of CDSCs capital stock. CDSC is determined to be a 41.59% ownership interest in CDSC. APC’s ownership percentage inVIE and APC is determined to be the primary beneficiary. APC has the ability to direct the activities that most significantly affect CDSC’s capital stock increased to 43.43% on July 31, 2016.economic performance and receives the most economic benefits; therefore 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.
APC-LSMA Designated Shareholder Medical Corporation ("APC-LSMA"(“APC-LSMA”) was formed onin October 15, 2012 as a designated shareholder professional corporation. Dr. Thomas Lam, a shareholderstockholder and the Chief Executive Officer and Chief Financial Officer of APC and Co-Chief Executive Officer of ApolloMed, is a nominee shareholder of APC. APC makes all investment decisions on behalf of APC-LSMA, funds all investments and receives all distributions from the investments. APC has the obligation to absorb losses and right to receive benefits from all 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 as the primary beneficiary of this VIE. The only activity of APC-LSMA is to hold the investments in medical corporations, including the IPA lines of business of LaSalle Medical Associates (“LMA”), Pacific Medical Imaging and Oncology Center, Inc. (“PMIOC”), Diagnostic Medical Group (“DMG”) and AHMC International Cancer Center, a Medical Corporation (“ICC”). APC-LSMA also holds a 100% ownership interest in Maverick Medical Group, Inc. (“MMG”), Alpha Care Medical Group, Inc. (“Alpha Care”), Accountable Health Care IPA, a Professional Medical Corporation ("(“Accountable Health Care"Care”), and AMG, a Professional Medical Corporation ("AMG"(“AMG”).
Alpha Care, an IPA whichacquired by the Company acquired onin May 31, 2019, has been operating in California since 1993 isas a risk bearing organization engaged in providing professional services under capitation arrangements with its contracted health plans through a provider network consisting of primary care and specialty care physicians. Alpha Care specializes in delivering high-quality healthcare to overapproximately 170,000 enrollees, as of SeptemberJune 30, 2019,2020, and focuses on Medi-Cal/Medicaid, Commercial, and Medicare and Dual Eligible members in the Riverside and San Bernardino counties of Southern California.
Accountable Health Care is a California basedCalifornia-based IPA 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 Health Care currently has a network of over 400 primary care physicians and 700 specialty care physicians, and five4 community and regional hospital medical centers that provide quality health care services to more than 89,000approximately 80,000 members of three3 federally qualified health plans and multiple product lines, including Medi-Cal, Commercial, Medicare and the California Healthy Families program. OnIn August 30, 2019, APC and APC-LSMA acquired the remaining outstanding shares of Accountable Health Care’s capital stock that they did not already own (comprising 75%) and as such as of September 30, 2019, Accountable Health Care is 100% ownedfor $7.3 million in cash (see Note 3 and Note 5)3).
AMG is a network of family practice clinics operating out of three3 main locations in Southern California. AMG provides professional and post-acute care services to Medicare, Medi-Cal/Medicaid, and Commercial patients through its networksnetwork of
12

doctors and nurse practitioners. OnIn September 10, 2019, APC-LSMA a holding company of APC, agreed to purchase and acquirepurchased 100% of the

aggregate issued and outstanding shares of capital stock of AMG for $1.2 million in cash and $0.4 million of APC common stock (see Note 3).
ICC was formed on September 2, 2010 in the state of California. ICC is a professional medical corporation that 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 were completed in August 2017 and effective on October 31, 2017, ICC was consolidated by APC as a VIE 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 onin June 4, 2014, for the purpose of holding an investment in Universal Care, Inc. (“UCI”). On April 30, 2020, UCAP completed the sale of its 48.9% ownership interest in UCI to Bright Health Company of California, Inc. ("Bright") for approximately $69.2 million in cash proceeds (including $16.5 million as repayment of indebtedness owed to APC), plus non-cash consideration consisting of shares of Bright Health, Inc.'s preferred stock having an estimated fair value of approximately $36.2 million on the date of sale. In addition, pursuant to the terms of the stock purchase agreement, APC has a beneficial interest in the equity method investment sold. The estimated fair value of such interest on April 30, 2020 was $15.7 million (see Note 5). As set forth in the Company’s definitive proxy statement filed with the SEC on July 31, 2019 (the “Proxy Statement”), the 48.9% interest in UCI is an “Excluded Asset” that remains solely for the benefit of APC and its shareholders. As such, any proceeds or gain on the sale of APC’s indirect ownership interest in UCI has no impact on the Series A Dividend payable by APC to AP-AMH Medical Corporation as described in the Proxy Statement and consequently the sale did not affect net income attributable to ApolloMed.
APAACO, jointly owned by NMM and AMM, began participating in the next generation accountable care organization modelNext Generation Accountable Care Organization (“NGACO Model”NGACO") Model of the Centers for Medicare & Medicaid Services ("CMS"(“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, a Medical Corporation (“AMH”), a hospitalist company, and Southern California Heart Centers, a Medical Corporation (“SCHC”), Bay Area Hospitalist Associates, Inc. (“BAHA”), a Medical Corporation, ApolloMed Care Clinic, a Professional Corporation (“ACC”) and AKM Medical Group, Inc. (“AKM”). AMH provides hospitalist, intensivist, and physician advisoradvisory 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, Inc. ("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.
AP-AMH Medical Corporation (“AP-AMH”) was formed on May 7, 2019 as a designated shareholder professional corporation. Dr. Thomas Lam, a shareholder,

2. Basis of Presentation and the Chief Executive Officer and Chief Financial OfficerSummary of APC and Co-Chief Executive Officer of ApolloMed, is the sole shareholder of AP-AMH. ApolloMed makes all the decisions on behalf of AP-AMH and funds and receives all the distributions from its operations. ApolloMed has the rights to receive benefits from the operations of AP-AMH and has the option, but not the obligation, to cover losses. Therefore, AP-AMH is controlled and consolidated by ApolloMed as the primary beneficiary of this VIE.Significant Accounting Policies
2.Basis of Presentation
Basis of Presentation
The accompanying condensed consolidated balance sheetsheets at December 31, 2018,2019, has been derived from the Company’s audited consolidated financial statements, but does not include all disclosures required by generally accepted accounting principles generally accepted in the United States of America (“U.S. GAAP”). The accompanying unaudited condensed consolidated financial statements as of SeptemberJune 30, 20192020, and for the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, 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, 20182019 as filed with the U.S. Securities and Exchange Commission (“SEC”)SEC on March 18, 2019.16, 2020. 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. Operating results for the three and ninesix months ended SeptemberJune 30, 20192020, are not necessarily indicative of the results that may be expected for the year ending December 31, 20192020, or any future periods.

Principles of Consolidation
The condensed consolidated balance sheets as of SeptemberJune 30, 20192020 and December 31, 2018,2019, and the condensed consolidated statements of income for the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019,  include the accounts of ApolloMed, its consolidated subsidiaries, NMM, AMM, APAACO, and Apollo Care Connect; ApolloMed'sConnect, its consolidated VIE, AP-AMH; NMM’sAP-AMH, NMM's consolidated subsidiaries, and consolidated VIE, APC;APC, APC’s subsidiary, UCAP;UCAP, and APC’s consolidated VIEs, CDSC, APC-LSMA, ICC, and APC-LSMA’s consolidated subsidiaries Alpha Care. Effective on September 1, 2019, the condensed consolidated balance sheets as of September 30, 2019Care and the condensed consolidated statements of income for the three and nine months ended September 30, 2019, also include the accounts of Accountable Health Care.
All material intercompany balances and transactions have been eliminated in consolidation.

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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 condensed 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 (incurred, but not reported (“IBNR”) claims), determination of full-risk and shared-risk revenue and receivables (including constraints and completion factors, including historical medical loss ratios (“MLR”)), income taxes, valuation of share-based compensation and right-of-use ("ROU") 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 one1 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 one1 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 ninety90 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 SeptemberJune 30, 2019,2020, the Company’s deposit accounts with banks exceeded the FDIC’s insured limit by approximately $248.7 million.$290.9 million, including approximately $117.6 million in certificates of deposit that were recognized as investments in marketable securities. 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.

Restricted Cash

Restricted cash consists of cash held as collateral to secure standby letters of credits as required by certain contracts.
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 SeptemberJune 30, 20192020 and December 31, 2018, short-term2019, investments in marketable securities in the amountamounted to approximately $117.7 million and $116.5 million, respectively, and consisted of approximately $1.2 million, consist ofequity securities and certificates of deposit with various financial institutions, reported at par value, plus accrued interest, with maturity dates from four months to twelve24 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, management fee income and incentive receivables, 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 and 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 ourthe Company’s 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 nine months ended September 30, 2019,Other receivables consists of recoverable claims paid related to the 2019 APAACO performance year to be administered following instructions from CMS, fee-for-servicesfee-for-
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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.reimbursements.
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 analyzes 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.
Receivables are recorded when the Company is able to determine amounts receivable under theseapplicable contracts and/orand agreements based on information provided and collection is reasonably likely to occur. TheIn regards to the credit loss standard, the Company continuously monitors its collections of receivables and its policyour expectation is that the historical credit loss experienced across our receivable portfolio is materially similar to write off receivables when they are determined toany current expected credit losses that would be uncollectible.estimated under the current expected credit losses (CECL) model. As of SeptemberJune 30, 20192020 and December 31, 2018,2019 the Company’sCompany had $1.3 million and $2.9 million of allowance for doubtful accounts, was approximately $2.9 million and approximately $4.3 million, respectively.
Concentrations of Risks
The Company disaggregates revenue from contracts by service type and payor type. 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 and ninesix months ended SeptemberJune 30, 2020 and 2019 and 2018:(in thousands):
For the Three Months Ended June 30,
20202019
Commercial$25,479  $25,365  
Medicare62,038  57,965  
Medicaid68,450  36,277  
Other third parties9,202  10,443  
Revenue$165,169  $130,050  
For the Six Months Ended June 30,
Three Months Ended September 30,2019 2018
20202019
   
Commercial$25,429,304
 $28,463,636
Commercial$50,192  $50,383  
Medicare60,737,135
 79,117,660
Medicare126,918  95,063  
Medicaid61,189,161
 47,318,190
Medicaid134,897  61,647  
Other third parties8,704,624
 11,829,795
Other third parties18,267  18,713  
Revenue$156,060,224
 $166,729,281
Revenue$330,274  $225,806  

Nine Months Ended September 30,2019 2018
    
Commercial$75,883,004
 $83,830,517
Medicare155,729,758
 186,449,517
Medicaid122,836,562
 109,870,854
Other third parties27,417,637
 33,168,170
Revenue$381,866,961
 $413,319,058

The Company had major payors that contributed the following percentages of net revenue:

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For the Three Months Ended
September 30,
For the Three Months Ended
June 30,
2019 201820202019
   
Payor A12.0% 14.8%Payor A11.9 %13.7 %
Payor B11.7% 18.4%Payor B10.3 %12.6 %
Payor C*
 12.7%Payor C*10.5 %
Payor D12.0% 16.7%Payor D17.5 %13.7 %
Payor E19.9% *
Payor E12.4 %*
Payor FPayor F10.1 %*

For the Six Months Ended June 30,
20202019
Payor A11.9 %15.8 %
Payor B10.3 %14.3 %
Payor C*11.7 %
Payor D17.5 %*
Payor E12.9 %*
Payor F10.3 %*
* Less than 10% of total net revenues
 For the Nine Months Ended September 30,
 2019 2018
    
Payor A14.3% 13.4%
Payor B13.3% 16.9%
Payor C10.0% 13.1%
Payor D*
 15.6%
Payor E11.0% *

*Less than 10% of total net revenues
The Company had major payors that contributed to the following percentages of receivables and receivables – related parties:
As of June 30,
2020
As of December 31,
2019
Payor D12.4 %*
Payor G33.5 %30.4 %
Payor H35.1 %36.0 %
* Less than 10% of total receivables and receivables — related parties, before the allowance for doubtful accounts:net
 As of
September 30,
2019
 As of
December 31,
2018
    
Payor E18.1% *
Payor F28.0% 34.1%
Payor G29.1% 42.2%
*Less than 10% of total receivables and receivables - related parties, net
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, capitalfinance lease obligations, and long-term debt. 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, capitalfinance lease obligations and long termlong-term debt 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”) ASCAccounting Standards Codification (“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 disclosuresdisclosure of the inputs to valuations used to measure fair value.
This hierarchy prioritizes the inputs into three broad levels as follows:
Level 1 —Inputs — Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that can be accessed at the measurement date.

Level 2 —Inputs — 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
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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 — 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 SeptemberJune 30, 20192020, are presented below:below (in thousands):
Fair Value Measurements  Fair Value Measurements
Level 1 Level 2 Level 3 TotalLevel 1Level 2Level 3Total
Assets       Assets
Money market funds*$194,428,575
 $
 $
 $194,428,575
Money market funds*$108,195  $—  $—  $108,195  
Marketable securities – certificates of deposit1,087,197
 
 
 1,087,197
Marketable securities – certificates of deposit117,611  —  —  117,611  
Marketable securities – equity securities67,283
 
 
 67,283
Marketable securities – equity securities45  —  45  
       
Total$195,583,055
 $
 $
 $195,583,055
Total$225,851  $—  $—  $225,851  
The carrying amounts and fair values of the Company’s financial instruments as of December 31, 20182019, are presented below:below (in thousands):
Fair Value Measurements
Level 1Level 2Level 3Total
Assets
Money market funds*$50,731  $—  $—  $50,731  
Marketable securities – certificates of deposit116,469  —  —  116,469  
Marketable securities – equity securities70  —  —  70  
Total$167,270  $—  $—  $167,270  
 Fair Value Measurements  
 Level 1 Level 2 Level 3 Total
Assets       
Money market funds*$85,500,745
 $
 $
 $85,500,745
Marketable securities – certificates of deposit1,066,103
 
 
 1,066,103
Marketable securities – equity securities60,999
 
 
 60,999
        
Total$86,627,847
 $
 $
 $86,627,847
Included in cash and cash equivalents
There were no Level 2 or Level 3 inputs measured on a recurring basis for the nine months ended September 30, 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 and ninesix months ended SeptemberJune 30, 2019.2020.
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 no0 impairment of its finite-lived intangible or long-lived assets during the ninesix months ended SeptemberJune 30, 20192020 and 2018.2019.
Goodwill and Indefinite-Lived Intangible Assets

Under ASC 350, Intangibles – Goodwill and Other (“ASC 350”), goodwill and indefinite-lived intangible assets are reviewed at least annually for impairment.
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At least annually, at the Company’s fiscal year end,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 three3 main reporting units (1) management services, (2) IPAs, and (3) ACOs. 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 had no0 impairment of its goodwill or definite-livedindefinite-lived intangible assets during the ninesix months ended SeptemberJune 30, 20192020 and 2018. However, during the three months ended September 30, 2019, the Company wrote off indefinite-lived intangible assets of $2.0 million related to Medicare licenses it acquired as part of the Merger. The Company will no longer utilize the licenses and as such will not receive future economic benefits.2019.
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. Under the equity method of accounting, the investment, originally recorded at cost, is adjusted to recognize the Company’s share of net earnings or losses of the investee and is recognized in the accompanying condensed consolidated statements of income under “Income (loss) from equity method investments” and also is adjusted by contributions to and distributions from the investee. Equity method investments are subject to impairment evaluation. On March 31, 2019,
Investments in Privately Held Entities
The Company accounts for certain investments using the cost method of accounting when it is determined that the investment provides the Company with little or no influence over the investee. Under the cost method of accounting, the investment is measured at cost, adjusted for observable price changes and impairments, with changes recognized an impairment loss of $0.3 million related to its investment in Pacific Ambulatory Surgery Center, LLC (“PASC”) (included in loss from equity methodnet income. The investments in the accompanying condensed consolidated statementsprivately held entities that do not report NAV are subject to qualitative assessment for indicators of income) as the Company does not expect to recover its investment (see Note 5).impairments.
Medical Liabilities
APC, including Alpha Care, and Accountable Health Care, APAACO and MMG are responsible for integrated care that the associated physicians and contracted hospitals provide to itstheir enrollees. APC, including Alpha Care, and Accountable Health Care, 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”) 2014-9, “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 partythird-party payors (e.g., hospitals and IPAs); and (v) individual patients and clients.
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Nature of Services and Revenue Streams
Revenue primarily consists of capitation revenue, risk pool settlements and incentives, NGACO All-Inclusive Population-Based Payments (“AIPBP”), 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, netNet
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 amount 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 and Accountable Health Care enterenters 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 and Accountable Health Care areis responsible for providing, arranging and paying for professional risk. Under a full risk pool sharing agreement, APC and Accountable Health Care generally receivereceives a percentage of the net surplus from the affiliated hospital’s risk pools with HMOs after deductions for the affiliated hospital’shospitals costs. Advance settlement payments are typically made quarterly in arrears if there is a surplus. RiskThe Company’s risk pool settlements under arrangements with health plans and hospitals are recognized using the most likely amount 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 factorfactors and constraint percentages were used by management in applying the most likely amount method.methodology.

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 enrollees'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 sharingrisk-sharing surpluses are generated. At the termination of the HMO contract, any accumulated deficit will be extinguished.
Risk
The Company’s risk pool settlements under arrangements with HMOs are recognized, using the most likely amount methodology, and only included in revenue to the extent that it is probable that a significant reversal of cumulative revenue will not occur. Given
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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. Final settlement of riskRisk pools for a giventhe prior contract yearyears are generally occurfinal 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 its efforts it takes to improve the quality of services and for efficient and effective use of pharmacy supplemental benefits provided to the HMOs'HMO members. The incentive programs track specific performance measures and calculate payments to the Company based on the performance measures. Incentives earnedThe Company’s incentives under “pay-for-performance” programs are recognized using the most likely amount 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 ACONGACO Model Participation Agreement (the “Participation Agreement”) with an initial term of two performance years through December 31, 2018, which has beenterm was extended for another two additional renewal years.
For each performance year, the Company shallmust 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 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. Excess over claims paid, plus an estimate for the related IBNR claims (see Note 8), and 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 paypays 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 shallwill 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 shallwill pay CMS in full within 30 days after the relevant settlement report is deemed final. If the
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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 shallwill 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 patientspatients.
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 claims, risk adjustment factors, and 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 likely be recognized in the future and therefore this shared risk pool revenue is considered fully constrained.
For performance year 2018,2020, the Company receivedcontinues to receive monthly AIPBP payments at a rate of approximately $7.3$7.6 million per month from CMS, that started in February 2018, which was reduced to $5.5 million per month beginning October 1, 2018. The Companyand 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 received by the Company for performance year 2019 was approximately $8.3 million per month for the period beginning April 1, 2019 through August 30, 2019. Subsequently, CMS adjusted the AIPBP payments to approximately $3.7 million for the period starting September 1, 2019 based on CMS' updated estimate of total claims to be incurred. The Company has received approximately $45.0$22.9 million and $45.5 million in total AIPBP payments for the ninethree and six months ended SeptemberJune 30, 20192020, respectively, of which $36.5$20.5 million and $42.4 million has been recognized as revenue.revenue for the three and six months ended June 30, 2020, respectively. The Company also recorded assets of approximately $11.4$8.5 million related to recoverableIBNR claims paid during the nine months ended Septemberas of June 30, 2019 which will be administered following instructions from CMS2020, and $3.0$3.2 million related to final settlement of the 20172018 performance year. These balances are included in “Other receivables” in the accompanying condensed consolidated balance sheet.sheets.
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 respectiveapplicable agreement. The Company’s Management Services Agreement ("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., ten10 years), although they may be terminated earlier under the terms of the respectiveapplicable 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-Services
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 condensed
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consolidated 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 together 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 no change in the Company'sCompany’s method to recognize revenue under ASC 606 Revenue from Contracts with Customersfrom 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'spatient’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 partythird-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'sCompany’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 statementstatements 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
The Company does not have material amounts of other contract assets.
The Company'ss 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.

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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 $17.0$3.1 million and $9.1$8.9 million as of SeptemberJune 30, 20192020, and December 31, 2018,2019, respectively, and is presented within “Accounts payable and accrued expenses” in the accompanying condensed consolidated balance sheets. During the ninesix months ended SeptemberJune 30, 2019, $0.52020, $0.4 million of the Company’s contract liability accrued in 20182019 has been recognized as revenue.revenue and $8.5 million was repaid back to CMS for AIPBP capitation received and not earned.
LeasesOther Financial Information
On January 1, 2019,In March 2020, the Company adopted ASU 2016-2, “Leases (Topic 842).” Refermade a deposit of $4.0 million for future investment opportunities. The investment was made with cash strictly related to “Recent Accounting Pronouncements” below and to Note 16 – Leases for further details.
the APC excluded assets that was generated from the series of transactions with AP-AMH. The Company determines if an arrangementdeposit is a lease at inception. Operating leases are included in “Right-of-use“Other assets” and “Operating lease liabilities” in the accompanying condensed consolidated balance sheets. Finance leases are included in “Land, property and equipment, net” and “Finance lease liabilities” 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 the Company's leases provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of future payments. The Company's lease terms may include options to extend or terminate the lease when it is reasonably certain that it will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term.
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 condensed consolidated 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 condensed consolidated financial statements.
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 period of the awards, adjusted for expected forfeitures. From time to time, 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 time-based and performance-based vesting schedules.
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 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 14 for a discussion of shares treated as treasury shares for accounting purposes.
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 equity ownership interests held by certain VIEs) in the Company’s consolidated entities. The amount of netNet income attributable to noncontrolling interests is disclosed in the condensed consolidated statements of income.
Mezzanine Equity
Pursuant to APC’s shareholder agreements, in the event of a disqualifying event, as defined in the agreements, APC could be required to repurchase the shares from the respective shareholders based on certain triggers outlined in the shareholder agreements. As the redemption feature 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 mezzanine or temporary equity. Accordingly, the Company recognizes
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noncontrolling interests in APC as mezzanine equity in the condensed consolidated financial statements. APC’sAs of June 30, 2020 and December 31, 2019, APC's shares arewere not redeemable, andnor was it was not probable that the shares would become redeemable as of September 30, 2019 and December 31, 2018.redeemable.
Recent Accounting Pronouncements
In February 2016, the FASB issued ASU No. 2016-2, “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 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 16 – 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 16 – Leases for further details.
In June 2016, the FASB issued ASUAccounting Standards Update (“ASU”) No. 2016-13, “FinancialFinancial Instruments-Credit Losses (Topic 326)-Measurement of Credit Losses on Financial Instruments”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 becomebecame effective for fiscal years beginning after December 15, 2019, with early adoption permitted. The Company is currently evaluating the impactadopted 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, 2019.2020. The adoption of ASU 2017-112016-13 did not have a material impact on the Company’s condensed consolidated financial statements.
In October 2018, the FASB issued ASU No. 2018-17, “ConsolidationConsolidation (Topic 810): Targeted Improvements to Related Party Guidance for Variable Interest Entities”Entities (“ASU 2018-17”). This ASU reduces the cost and complexity of financial reporting associated with consolidation of variable interest entities (VIEs).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 arebecame effective for fiscal years beginning after December 15, 2019, and interim periods within those fiscal years. The Company adopted ASU 2018-17 on January 1, 2020. The adoption of ASU 2018-17 did not have a material impact on the consolidated financial statements.

In December 2019, the FASB issued ASU No. 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes (“ASU 2019-12”). This ASU simplifies the accounting for income taxes by eliminating certain exceptions to the guidance in ASC 740 Income Taxes related to the approach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period and the recognition of deferred tax liabilities for outside basis differences. The amendments in this ASU are effective for fiscal years beginning after December 15, 2020, and interim periods within those fiscal years. The Company is currently assessing the impact that the adoption of ASU 2018-172019-12 will have on the Company’s condensedCompany's consolidated financial statements.
With
In January 2020, the exceptionFASB issued ASU No. 2020-01, Investments - Equity Securities (Topic 321), Investments - Equity Method and Joint Ventures (Topic 323), and Derivatives and Hedging (Topic 815) (“ASU 2020-01”). This ASU clarifies the interaction between accounting for equity securities, equity method investments and certain derivative instruments. The amendments in this ASU are effective for fiscal years beginning after December 15, 2020, and interim periods within those fiscal years. The Company is currently assessing the impact that the adoption of ASU 2020-01 will have on the newCompany's consolidation financial statements.
Other than the 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.
3.Business Combination and Goodwill

3. Business Combinations and Goodwill
Alpha Care Medical Group, Inc.
On May 31, 2019, APC and APC-LSMA completed their acquisition of 100% of the capital stock of Alpha Care from Dr. Kevin Tyson for an aggregate purchase price of approximately $45.1 million in cash, subject to post-closing adjustments. As part of the transaction the Company deposited $2.0 million into an escrow account for potential post-closing adjustments. As of SeptemberJune 30, 20192020, no post-closing adjustment is expected to be paid to Dr. Tyson and the full amount of the escrow account is expected to be returned to the Company. As such, the escrow amount is presented within Prepaidprepaid expenses and other current assets in the accompanying condensed consolidated balance sheets.
The following table summarizes the estimated fair values of the assets acquired and liabilities assumed, as of the acquisition date:date (in thousands):
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Preliminary
Balance Sheet
Assets acquired 
Cash and cash equivalents$3,568,554
Accounts receivable, net10,335,664
Other current assets2,004,649
Network relationship intangible assets29,858,000
Goodwill24,637,507
Accounts Payable(2,273,753)
Deferred tax liabilities(8,355,343)
Medical liabilities(14,719,714)
    Net assets acquired$45,055,564
  
Cash paid$45,055,564
Balance Sheet
Assets acquired
Cash and cash equivalents$3,569 
Accounts receivable, net10,336 
Other current assets4,675 
Network relationship intangible assets22,636 
Goodwill28,585 
Accounts payable(2,795)
Deferred tax liabilities(6,334)
Medical liabilities(15,616)
    Net assets acquired$45,056 
Cash paid$45,056 


Accountable Health Care, IPA, a Professional Medical Corporation
On August 30, 2019, APC and APC-LSMA acquired the remaining outstanding shares of capital stock (comprising 75%) in Accountable Health Care in exchange for $7.3 million. In addition to the payment of $7.3 million, APC assumed all assets and liabilities of Accountable Health Care, including loans payable to NMM and APC of $15.4 million, which hashave been eliminated upon consolidation and contributed the 25% investment totaling $2.4 million, total purchase price was $25.1 million (see Note 5).

The following table summarizes the estimated fair values of the assets acquired and liabilities assumed, as of the acquisition date:date (in thousands):
Balance Sheet
Assets acquired
Cash and cash equivalents$582 
Accounts receivable, net5,150 
Other current assets198 
Network relationship intangible assets11,411 
Goodwill23,566 
Accounts payable(3,759)
Medical liabilities(12,154)
Subordinated loan(15,327)
Net asset acquired$9,667 
Equity investment contributed$2,417 
Cash paid$7,250 
 
Preliminary
Balance Sheet
Assets acquired 
Cash and cash equivalents$581,965
Accounts receivable, net5,150,060
Other current assets198,056
Network relationship intangible assets11,411,000
Goodwill25,604,917
Accounts Payable(2,993,325)
Deferred tax liabilities(3,193,209)
Medical liabilities(11,684,658)
Subordinated Loan(15,408,138)
Net asset acquired$9,666,668
  
Equity investment contributed$2,416,668
Cash paid$7,250,000
AMG, a Professional Medical Corporation
The Company also completed one additional acquisition onacquired AMG in September 10, 2019, for total consideration of $1.7$1.6 million, of which $0.4 million was in the form of APC common stock. The business combination did not meet the quantitative thresholds to require separate disclosures based on the Company'sCompany’s consolidated net assets, investments and net income.
The acquisitions were accounted for under the purchaseacquisition method of accounting. The purchasefair value of the consideration offor the acquired company was allocated to acquired tangible and intangible assets and liabilities based upon their fair values. The excess of the purchase consideration over the fair value of the net tangible and identifiable intangible assets acquired werewas recorded as goodwill. The determination of the fair value of assets and liabilities acquired requires the Company to make estimates and use valuation techniques when market value is not readily available. The results of operations of the company
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acquired have been included in the Company'sCompany’s financial statements from the date of acquisition. Transaction costs associated with business acquisitions are expensed as they are incurred.
At the time of acquisition, the Company estimates the amount of the identifiable intangible assets based on a valuation and the facts and circumstances available at the time. The Company determines the final value of the identifiable intangible assets as soon as information is available, but not more than 12 monthsone year from the date of acquisition.
Goodwill is not deductible for tax purposes.
The change in the carrying value of goodwill for the ninesix months ended SeptemberJune 30, 2019 is2020, was as follows;follows (in thousands);
Balance, January 1, 2019$185,805,880
  
Acquisition of Alpha Care24,637,507
Acquisition of AMG1,086,468
Acquisition of Accountable Health Care25,604,917
  
Balance, September 30, 2019$237,134,772



Balance, January 1, 2020$238,505 
Adjustments548 
4.Balance, June 30, 2020Intangible Assets, Net$239,053 

4. Intangible Assets, Net
At SeptemberJune 30, 2020, the Company’s intangible assets, net, consisted of the following (in thousands):
Useful
Life
(Years)
Gross June 30,
2020
Accumulated
Amortization
Net June 30,
2020
Amortized intangible assets:
Network relationships11-15$143,930  $(67,015) $76,915  
Management contracts1522,832  (10,736) 12,096  
Member relationships126,696  (2,793) 3,903  
Patient management platform52,060  (1,064) 996  
Trade names/trademarks201,011  (131) 880  
$176,529  $(81,739) $94,790  
At December 31, 2019, the Company’s intangible assets, net, consisted of the following:following (in thousands):
 
Useful
Life
(Years)
 Gross
September 30,
2019
 
Accumulated
Amortization
 Net
September 30,
2019
Indefinite lived assets:       
Medicare licenseN/A $
 $
 $
Amortized intangible assets:       
Network relationships11-15 151,152,000
 (57,503,773) 93,648,227
Management contracts15 22,832,000
 (9,146,391) 13,685,609
Member relationships12 6,696,000
 (2,086,523) 4,609,477
Patient management platform5 2,060,000
 (755,333) 1,304,667
Tradename/trademarks20 1,011,000
 (92,675) 918,325
   $183,751,000
 $(69,584,695) $114,166,305
At December 31, 2018, the Company’s intangible assets, net, consisted of the following:
Useful
Life
(Years)
Gross December 31,
2019
Accumulated
Amortization
Net December 31, 2019
Useful
Life
(Years)
 Gross
December 31,
2018
 
Accumulated
Amortization
 Net
December 31,
2018
Indefinite lived assets:      
Medicare licenseN/A $1,994,000
 $
 $1,994,000
Amortized intangible assets:      Amortized intangible assets:
Network relationships11-15 109,883,000
 (48,361,773) 61,521,227
Network relationships11-15$143,930  $(60,526) $83,404  
Management contracts15 22,832,000
 (7,447,581) 15,384,419
Management contracts1522,832  (9,676) 13,156  
Member relationships12 6,696,000
 (1,289,667) 5,406,333
Member relationships126,696  (2,352) 4,344  
Patient management platform5 2,060,000
 (446,333) 1,613,667
Patient management platform52,060  (858) 1,202  
Tradename/trademarks20 1,011,000
 (54,763) 956,237
Trade names/trademarksTrade names/trademarks201,011  (105) 906  
 $144,476,000
 $(57,600,117) $86,875,883
$176,529  $(73,517) $103,012  
Included in depreciation and amortization on the accompanying condensed consolidated statements of income is amortization expense of $4.3$4.1 million and $4.2$3.9 million (excluding $0.1 million of amortization expense for exclusivity incentives) for the three months ended SeptemberJune 30, 20192020 and 2018,2019, respectively, and $12.0$8.2 million and $12.8$7.7 million (excluding $0.3 million of amortization expense for exclusivity incentives) for the ninesix months ended SeptemberJune 30, 2020 and 2019, and 2018, respectively.
During the three and nine months ended September 30, 2019, the Company wrote off indefinite-lived intangible assets of $2.0 million related to Medicare licenses it acquired as part of the Merger. The Company will no longer utilize these licenses and as such the Company will not receive future economic benefits.
Future amortization expense is estimated to be as follows for the following years ending December 31:31 (in thousands):
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Amount
Amount
 
2019 (excluding the nine months ended September 30, 2019)$4,212,000
202015,757,000
2020 (excluding the six months ended June 30, 2020)2020 (excluding the six months ended June 30, 2020)$7,807  
202114,436,000
202114,524  
202213,559,000
202212,673  
202312,341,000
202310,842  
202420249,830  
Thereafter53,861,000
Thereafter39,114  
 
Total$114,166,000
Total$94,790  

5.Investments in Other Entities - Equity Method

5. Investments in Other Entities — Equity Method
Rollforward of Equity Method Investment Summary(in thousands)
Investments in other entities – equity method consisted of the following:
December 31,
2019
Allocation of Income (Loss)ContributionSaleJune 30,
2020
LaSalle Medical Associates – IPA Line of Business$6,397  $(428) $—  $—  $5,969  
Pacific Medical Imaging & Oncology Center, Inc.1,396  77  —  —  1,473  
Universal Care, Inc.1,438  3,560  —  (4,998) —  
Diagnostic Medical Group2,334  (102) —  —  2,232  
531 W. College, LLC – related party16,698  (231) 500  —  16,967  
MWN, LLC – related party164  12  —  —  176  
$28,427  $2,888  $500  $(4,998) $26,817  
 September 30,
2019
 December 31,
2018
LaSalle Medical Associates – IPA Line of Business$6,426,903
 $7,054,888
Pacific Medical Imaging & Oncology Center, Inc.1,542,506
 1,359,494
Universal Care, Inc.8,794,659
 2,635,945
Accountable Health Care - related party
 4,977,957
Diagnostic Medical Group2,714,008
 2,257,346
Pacific Ambulatory Surgery Center, LLC
 285,198
531 W. College, LLC – related party16,139,073
 16,273,152
MWN, LLC – related party222,956
 33,000
 $35,840,105
 $34,876,980
LaSalle Medical Associates - IPA Line of Business
FoundedLMA was founded by Dr. Albert Arteaga in 1996 LaSalle Medical Associates (“LMA”)and currently operates four6 neighborhood medical centers employing more than 120 dedicated healthcare professionals,through its network of approximately 2,300 PCP and Specialists providers, treating children, adults and seniors in San Bernardino County, California. LMA’s patients are primarily served by Medi-Cal. LMA also accepts Blue Cross, Blue Shield, Molina, Care 1st, Health Net and Inland Empire Health Plan. LMA is also an IPA of independently contracted doctors, hospitals and clinics, delivering high qualityhigh-quality care to more than 319,000approximately 290,000 patients in Fresno, Kings, Los Angeles, Madera, Riverside, San Bernardino and Tulare Counties. During 2012, APC-LSMA and LMA entered into a share purchase agreement whereby APC-LSMA invested $5.0 million for a 25% interest in LMA’s IPA line of business. NMM has a management services agreement with LMA. APC accounts for its investment in LMA under the equity method as APC has the ability to exercise significant influence, but not control over LMA’s operations. For the three months ended SeptemberJune 30, 2019 and 2018,2020, APC recorded losses andrecognized income from this investment of $0.2 million. For the three months ended June 30, 2019, APC recognized a loss from this investment of $1.3 million. For the six months ended June 30, 2020 and 2019, APC recognized losses of $0.4 million and $0.2$2.4 million, respectively, in the accompanying condensed consolidated statements of income. For the nine months ended September 30, 2019 and 2018, APC recorded losses from this investment of $2.8 million and $0.8 million, respectively, in the accompanying condensed consolidated statements of income. During the period ended September 30, 2019, the Company contributed $2.1 million to LMA as part of its 25% interest. The accompanying condensed consolidated balance sheets include the related investment balance of $6.0 million and $6.4 million and $7.1 million at SeptemberJune 30, 20192020 and December 31, 2018,2019, respectively.
LMA’s summarized balance sheets at SeptemberJune 30, 20192020 and December 31, 20182019, and summarized statements of operations for the ninesix months ended SeptemberJune 30, 20192020 and 20182019, with respect to its IPA line of business are as follows:follows (in thousands):

27


Balance Sheets
June 30,
2020
December 31,
2019
Assets
Cash and cash equivalents$2,852  $6,345  
Receivables, net6,751  5,124  
Other current assets880  3,526  
Loan receivable2,250  2,250  
Restricted cash688  683  
Total assets$13,421  $17,928  
Liabilities and Stockholders’ (Deficit) Equity
Current liabilities$20,735  $23,530  
Stockholders’ deficit(7,314) (5,602) 
Total liabilities and stockholders’ deficit$13,421  $17,928  
 September 30,
2019
 December 31,
2018
Assets   
    
Cash and cash equivalents$3,237,833
 $18,444,702
Receivables, net7,778,735
 2,897,337
Other current assets3,526,319
 5,459,442
Loan receivable2,250,000
 1,250,000
Restricted cash680,216
 667,414
    
Total assets$17,473,103
 $28,718,895

Liabilities and Stockholders’ (Deficit) Equity
 September 30,
2019
 December 31,
2018
Current liabilities$22,953,961
 $26,837,814
Stockholders’ (deficit) equity(5,480,858) 1,881,081
    
Total liabilities and stockholders’ (deficit) equity$17,473,103
 $28,718,895

Statements of Operations
Six Months Ended June 30,
20202019
Revenues$92,113  $93,434  
Expenses93,680  102,845  
Net loss$(1,567) $(9,411) 
 Nine Months
Ended
September 30,
2019
 Nine Months
Ended
September 30,
2018
Revenues$144,569,818
 $177,696,760
Expenses155,581,757
 180,445,655
    
Net loss$(11,011,939) $(2,748,895)

Pacific Medical Imaging and Oncology Center, Inc.
Incorporated in California in 2004, PMIOC provides comprehensive diagnostic imaging services using state-of-the-art technology. PMIOC offers high qualityhigh-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 interest in PMIOC.
Pursuant to
APC and PMIOC have an Ancillary Service Contract with APC,together whereby PMIOC provides covered services on behalf of APC to enrollees under APC's health plans.of the plans of APC. Under the Ancillary Service Contract, APC paid PMIOC fees of approximately $0.7$0.4 million and $0.7$0.6 million, for the three months ended SeptemberJune 30, 20192020 and 2018,2019, respectively, and fees of approximately $2.1$1.0 million and $1.9$1.4 million for the ninesix months ended SeptemberJune 30, 20192020 and 2018, respectively.2019. 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. DuringFor the three months ended SeptemberJune 30, 2020, APC recognized a loss from this investment of $10,200. For the three months ended June 30, 2019, and 2018, APC recordedrecognized income from this investment of approximately $31,230$0.1 million. For the six months ended June 30, 2020 and $4,990,2019, APC recognized income of $0.1 million and $0.2 million, respectively, in the accompanying condensed consolidated statements of income. For the nine months ended September 30, 2019 and 2018, APC recorded income from this investment of $0.2 million and $41,571, respectively, in the accompanying condensed consolidated statements of income. The accompanying condensed consolidated balance sheets include the related investment balancesbalance of $1.5 million and $1.4 million at SeptemberJune 30, 20192020 and December 31, 2018,2019, respectively.
28

Universal Care, Inc.
UCI is a privately held health plan that has been in operation since 1985. UCI holds a license under the California Knox-Keene Health Care Services Plan Act to operate as a full-service health plan. UCI contracts with CMS under the Medicare Advantage Prescription Drug Program.
OnIn August 10, 2015, UCAP purchased 100,000 shares of UCI class A-2 voting common stock from UCI for $10.0 million, which shares comprise 48.9% of UCI'sUCI’s total outstanding shares and 50% of UCI’s voting common stock. APC accounts for
On April 30, 2020, UCAP completed the sale of its investment48.9% ownership interest in UCI underto Bright for approximately $69.2 million in cash proceeds (including $16.5 million as repayment of indebtedness owed to APC), plus non-cash consideration consisting of shares of Bright Health, Inc.’s preferred stock having an estimated fair value of approximately $36.2 million on the date of sale, included in investments in privately held entities. The fair value of the preferred shares was determined utilizing a market approach which includes significant unobservable inputs (Level 3) including forecasted revenue along with estimates of revenue multiples, volatility and time-to-liquidity. In addition, pursuant to the terms of the stock purchase agreement, APC has a beneficial interest in the equity method investment sold. The estimated fair value of accountingsuch interest on April 30, 2020 was $15.7 million and is included in "Other assets" in the accompanying consolidated balance sheets. The beneficial interest is the result of a gross margin provision in the stock purchase agreement which entitles UCAP to potentially receive additional cash and preferred shares (currently held in an escrow account with cash of $15.6 million and preferred shares with an estimated fair value of $6.4 million, total estimated fair value of $22.0 million on the date of sale) based on the gross margin of UCI for calendar year 2020 as APC hasmeasured against a target. The amount to be received varies dependent upon the abilitygross margin as compared to exercisethe target but cannot exceed the amounts that are in the escrow account. Additionally, the stock purchase agreement includes a tangible net equity provision that may result in the receipt or payment of additional amounts based on a comparison of final tangible net equity of UCI on the date of sale (determined with the benefit of one year of hindsight) as compared to the estimated tangible net equity at the time of sale. It is expected that settlement of the beneficial interest will begin in the second half of 2021. The Company determined the fair value of the beneficial interest using an income approach which includes significant influence, but not control over UCI’s operations. Duringunobservable inputs (Level 3). Specifically, the Company utilized a probability weighted discounted cash flow model using a risk-free treasury rate to estimate fair value which considered various scenarios of gross margin adjustment and the impact of each adjustment to the expected proceeds from the escrow account and assigned probabilities to each such scenario in determining fair value. The gross margin adjustment is defined as three times any deficit in actual gross margin of UCI for the year ended December 31, 2020 below a target gross margin unless such deficit is within a specific collar amount.
The gain on sale of equity method investment recognized in connection with this transaction was determined as follows:
Amount (in '000s)
Cash proceeds (excludes proceeds to settle indebtedness owed to APC from UCI)$52,743 
Preferred shares in Bright Health, Inc.$36,179 
Beneficial interest in UCI$15,723 
Less: Carrying value of equity method investment on date of sale$(4,998)
Gain on sale of equity method investment$99,647 
For the three months ended SeptemberJune 30, 2020 and June 30, 2019 and 2018, the CompanyAPC recorded income and losses from this investment of approximately $0.6$0.9 million and $4.6 million, respectively, in$4.5 million. For the accompanying condensed consolidated statements of income. During the ninesix months ended SeptemberJune 30, 2020 and June 30, 2019 and 2018, the CompanyAPC recorded income and losses from this investment of approximately $6.2$3.6 million and $2.9$5.5 million respectively, in the accompanying condensed consolidated statements of income. The accompanying condensed consolidatedincome, respectively. As a result of the sale, there was 0 investment balance sheets include the relatedas of June 30, 2020 as compared to an investment balancesbalance of $8.8$1.4 million and $2.6 million at September 30, 2019 andas of December 31, 2018, respectively.2019.

UCI’sUCI's balance sheetssheet at September 30, 2019 and December 31, 20182019 and statements of income for the ninefour months ended SeptemberApril 30, 2020 and six months ended June 30, 2019 and 2018 are as follows:follows (in thousands):

29

Balance Sheets
 September 30,
2019
 December 31,
2018
Assets   
    
Cash$29,568,915
 $27,812,520
Receivables, net62,787,671
 46,978,703
Other current assets33,786,968
 18,670,350
Other assets10,799,827
 661,621
Property and equipment, net3,319,680
 2,786,996
    
Total assets$140,263,061
 $96,910,190
Liabilities and Stockholders’ Deficit
 September 30,
2019
 December 31,
2018
Current liabilities$120,698,226
 $89,731,133
Other liabilities25,067,577
 25,024,043
Stockholders’ deficit(5,502,742) (17,844,986)
    
Total liabilities and stockholders’ deficit$140,263,061
 $96,910,190
December 31,
2019
Assets
Cash and cash equivalents$33,890 
Receivables, net63,843 
Other current assets38,280 
Loan receivable882 
Restricted cash4,021 
Total assets$140,916 
Liabilities and Stockholders’ (Deficit) Equity
Current liabilities$128,330 
Other liabilities33,133 
Stockholders’ deficit(20,547)
Total liabilities and stockholders’ deficit$140,916 
Statements of IncomeOperations
 Nine Months
Ended
September 30,
2019
 Nine Months
Ended
September 30,
2018
Revenues$372,181,425
 $240,633,955
Expenses370,597,312
 246,765,335
    
Income before benefit from income taxes1,584,113
 (6,131,380)
Benefit from income taxes(11,010,394) (130,023)
    
Net income (loss)$12,594,507
 $(6,001,357)
Accountable Health Care – Related Party
Accountable Health Care 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 Health Care currently has a network of over 400 primary and 700 specialty care physicians, and five community and regional hospital medical centers that provide quality health care services to more than 89,000 members of three 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 Health Care 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 Health Care’s current enterprise value. APC accounts for its investment in Accountable Health Care under the equity method of accounting. On August 30, 2019 APC and APC-LSMA, in connection with the settlement of a dispute with Dr. Jayatilaka, acquired the remaining outstanding shares of capital stock (comprising 75%) in Accountable Health

Care in exchange for $7.3 million. In addition to the payment of $7.3 million APC assumed all liabilities and assets of Accountable Health Care (See Note 3).
The Company recognized a gain of approximately $1.8 million as a result of the transaction , which represented the difference between the fair value of the 25% ownership held and the Company's basis at the time of acquisition. Such gain is included in income from equity method investment in the accompanying condensed consolidated statements of income.
Effective September 1, 2019, Accountable Health Care's financial result is included in the condensed consolidated balance sheets as of September 30, 2019 and the condensed consolidated statements of income for the three and nine months ended September 30, 2019.
Four Months EndedSix Months Ended
April 30,
2020
June 30,
2019
Revenues$195,308  $247,517  
Expenses189,028  239,389  
Income before benefit from income taxes6,280  8,128  
Benefit from income taxes—  (3,167) 
Net income$6,280  $11,295  
Diagnostic Medical Group
OnIn May 14, 2016, David C.P. Chen M.D., Inc., a California professional corporation doing business as Diagnostic Medical Group (“DMG”), David C.P. Chen M.D., individually, and APC-LSMA, entered into a share purchase agreement whereby APC-LSMA acquired a 40% ownership interest in DMG for total cash consideration of $1.6 million.DMG.
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 SeptemberJune 30, 2020 and 2019, and 2018, APC recordedrecognized loss and income from this investment of $0.3$0.1 million and $0.2 million, respectively, in the condensed consolidated statements of income. For the ninesix months ended SeptemberJune 30, 2020 and 2019, and 2018, APC recordedrecognized loss and income from this investment of $0.7$0.1 million and $0.9$0.4 million, respectively, in the condensed consolidated statements of income. During the nine months ended September 30, 2019 the Company received dividends from its investment in DMG of $0.2 million. The accompanying condensed consolidated balance sheets include the related investment balances of $2.7$2.2 million and $2.3 million as of SeptemberJune 30, 20192020 and December 31, 2018,2019, 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 healthcare service plans, IPAs, medical groups and other purchasers of healthcare services for the provision of outpatient surgery center services to health plan subscribers and enrollees. 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.
During the nine months ended September 30, 2019, the Company recognized an impairment loss of $0.3 million related to its investment in PASC as the Company does not believe it will recover its investment balance. Such impairment loss is included in loss from equity method investment in the accompanying condensed consolidated statements of income.
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 and nine months ended September 30, 2018, APC recorded income from this investment of $0.1 million and $0.3 million, respectively, 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.
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.
On
30

In June 29, 2018, 531 W. College, LLC closed its purchase of a non-operational hospital located in Los Angeles from Societe Francaise De Bienfaisance Mutuelle De Los Angeles, a California nonprofit corporation, for a total purchase price of $33.3 million. On April 23, 2019, NMM and APC entered into an agreement whereby NMM assigned and APC assumed NMM'sNMM’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 $16.1$17.0 million.
APC accounts for its investment in 531 W. College, LLC under the equity method of accounting as APC has the ability to exercise significant influence, but not control over the operations of this joint venture. APC's investment is presented as an investment in other entities - equity method in the accompanying condensed consolidated balance sheet as of September 30, 2019 and December 31, 2018.

For the three and nine months ended SeptemberJune 30, 2020 and 2019, APC recognized loss and income of $0.1 million and $12,649, respectively. For the six months ended June 30, 2020 and 2019, APC recorded losses from its investmentof $0.2 million and $34,319 in the accompanying consolidated statements of income, respectively. During the period ended June 30, 2020, the Company contributed $0.5 million to 531 W. College LLC as part of $0.1its 50% interest and had investment balances of $17.0 million and $16.7 million, respectively, in the accompanying condensed consolidated statements of income. The accompanying condensed consolidated balance sheets include the related investment balance of $16.1 millionat June 30, 2020 and $16.3 million, respectively, related to APC’s investment at September 30, 2019 and APC's and NMM's investments at December 31, 2018.2019.
531 W. College LLC’s balance sheets at SeptemberJune 30, 20192020 and December 31, 20182019, and statements of operations for the ninesix months ended SeptemberJune 30, 20192020 and 20182019, are as follows:follows (in thousands):
Balance Sheetsheets
September 30,
2019
 December 31,
2018
June 30,
2020
December 31,
2019
Assets   Assets
   
Cash$31,986
 $158,088
Cash$126  $139  
Other current assets24,750
 16,137
Other current assets—  17  
Other assets70,000
 70,000
Other assets70  70  
   
Property and equipment, net$33,412,652
 $33,394,792
Property and equipment, net33,697  33,581  
   
Total assets$33,539,388
 $33,639,017
Total assets$33,893  $33,807  
   
Liabilities and Members’ Equity   Liabilities and Members’ Equity
   
Current liabilities$1,261,243
 $1,007,413
Current liabilities$1,109  $1,062  
Stockholders’ equity32,278,145
 32,631,604
Stockholders’ equity32,784  32,745  
   
Total liabilities and members’ equity$33,539,388
 $33,639,017
Total liabilities and members’ equity$33,893  $33,807  
Statements of Operation
Six Months Ended June 30,
20202019
Revenues—  —  
Expenses579  538  
Loss from operations(579) (538) 
Other income$21  $385  
Net loss$(558) $(153) 
 Nine Months
Ended
September 30,
2019
 Nine Months
Ended
September 30,
2018
Revenues
 
Expenses779,958
 181,359
Loss from operations(779,958) (181,359)
    
Other Income$426,500
 $25,650
    
Net loss$(353,458) $(155,709)

MWN LLC – Related Party
OnIn December 18, 2018, NMM, 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
31

MWN Community Hospital, LLC and the conduct of its business and to specify their relative rights and obligations. NMM, Pacific6, and HSMSO each ownsown 33.3% of the membership shares based on each member’s initial capital contributions of $3,000 and working capital contributions of $30,000. During the nine months ended September 30, 2019, NMM invested an additional $0.3 million for working capital purposes.purposes in August 2019. For the three and ninesix months ended SeptemberJune 30, 2019, APC2020, NMM recorded lossesloss and income from its investment in MWN LLC of $0.1 million,$43,000 and $12,000, respectively, in the accompanying condensed consolidated statements of income. The accompanying condensed consolidated balance sheets include the relatedincome and had an investment balance of $0.2 million and $33,000 as of SeptemberJune 30, 20192020 and December 31, 2018, respectively.2019.

InvestmentInvestments in privately held entityentities that doesdo not report net asset value per share
MediPortal, LLC
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 an approximately 2.8% ownership interest. In connection with the initial purchase, APC received a 5-yearfive-year warrant to purchase an additional 270,000 membership interests. Additionally, APC received a 5-yearfive-year option to purchase an additional 380,000 membership interests and a 5-yearfive-year warrant to purchase 480,000 membership interests, which MediPortal LLC will grant APC upon completion of its health portal. As of SeptemberJune 30, 2019,2020, the health portal has not been completed. As APC does not have the ability to exercise significant influence, and lacks control, over the investee, this investment is accounted for using a measurement alternative which allows the investment to be measured at cost, adjusted for observable price changes and impairments, with changes recognized in net income.
AchievaMed
On July 1, 2019, NMM and AchievaMed, Inc., a California corporation ("AchievaMed"(“AchievaMed”), entered into an agreement in which NMM would purchase 50% of the aggregate shares of capital stock of AchievaMed over a period of time not to exceed five years. As a result of this transaction NMM invested $0.5 million for a 10% interest. The related investment balance of $0.5 million is included in "Investment“Investment in a privately held entity that does not report net asset value per share"entities” in the accompanying condensed consolidated balance sheetsheets as of SeptemberJune 30, 2019.2020.
Bright Health, Inc.
6.Loan Receivable – Related Parties
In April 2020, UCAP completed the sale of its 48.9% ownership interest in UCI to Bright for approximately $69.2 million in cash proceeds (including $16.5 million as repayment of indebtedness owed to APC), plus non-cash consideration consisting of shares of Bright Health, Inc.’s preferred stock having an estimated fair value of approximately $36.2 million on the date of sale. The related investment balance of $36.2 million is included in “Investment in privately held entities” in the accompanying consolidated balance sheets as of June 30, 2020.

6. Loan Receivable and Loan Receivable – Related Parties
Loan receivable
Dr. Albert Arteaga
On June 28, 2019, APC entered into a convertible secured promissory note with Dr. Albert H. Arteaga, M.D. ("(“Dr. Arteaga"Arteaga”), Chief Executive Officer of LMA, to loan $6.4 million to Dr. Arteaga. Interest on the loan accrues at a rate that is equal to the prime rate, plus 1% (6.00%(4.25% as of SeptemberJune 30, 2019)2020) and payable in monthly installments of interest only on the first day of each month until the maturity date of June 28,December 31, 2020, at which time, all outstanding principal and accrued interest thereon shall be due and payable in full. The note is secured by certain shares of LMA common stock held by Dr. Arteaga.
At any time on or before December 31, 2019,2020, and upon written notice by APC to Dr. Arteaga, APC has the right, but not the obligation, to convert the entire outstanding principal amount of this note into shares of LMA common stock, which equal 21.25% of the aggregate then-issued and outstanding shares of LMA common stock to be held by APC'sAPC’s designee, which may include APC-LSMA. If converted, APC-LSMA and APC'sAPC’s designee will collectively own 46.25% of the equity of LMA with the remaining 53.75% to be owned by Dr. Arteaga. The entire note receivable has been classified under loans receivable - related parties on the condensed consolidated balance sheets in the amount of $6.4 million as of SeptemberJune 30, 2019.
Accountable Health Care IPA2020.
On AugustFebruary 28, 2020, the Company entered into an agreement to advance Dr. Arteaga $2.2 million related to claims that were overpaid in the ordinary course of business. The advanced amount is repaid as the overpaid claims are recovered. As of June 30, 2019, APC and APC-LSMA acquired2020, the remaining outstanding shares of capital stock (comprising 75%) in Accountable Health Care in exchange for $7.3 million. In addition to the payment of $7.3 million APC assumed all assets and liabilities of Accountable Health Care, these liabilities include the loan payableamount due to NMM of $5.0was $0.9 million and included in the remaining loan receivable of $7.3 million originally to be paid to George M. Jayatilaka, M.D.. As a result of the net loans assumed, APC recognized a gain of $2.3 million recorded in“Prepaid expenses and other incomecurrent assets” in the accompanying condensed consolidated statementsbalance sheets.
32

The Company assessed the loan payablesreceivables under the CECL model by assessing the party's ability to pay by reviewing their interest payment history quarterly, financial history annually and receivables has been eliminated upon consolidation. (See Note 3)reassessing any insolvency risk that is identified. If a failure to pay occurs, the Company assesses the terms of the notes and estimates an expected credit loss based on the remittance schedule of the note.
Loan receivable related parties
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, and December 13, 2019, APC advanced an additional $2.5 million, and $5.0 million and $4.0 million, respectively. These subordinatedThe loans accrue interest at the prime rate, plus 1.00%, or 6.00%4.25%, as of September 30, 2019March 31, 2020, and 6.50%5.75% as of December 31, 2018,2019, with interest to be paid monthly. The repayment schedule is based on certain contingent criteria,On April 30, 2020, the outstanding balance was fully repaid as part of UCAP's disposition of its 48.9% ownership interest in UCI to Bright.

7. Accounts Payable 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 September 30, 2019 and December 31, 2018.Accrued Expenses
7.Accounts Payable and Accrued Expenses
The Company’s accounts payable and accrued expenses consisted of the following:following (in thousands):

June 30,
2020
December 31,
2019
Accounts payable$10,425  $6,914  
Capitation payable2,754  2,813  
Subcontractor IPA payable3,083  3,360  
Professional fees2,325  1,837  
Due to related parties80  225  
Accrued compensation3,060  3,238  
Contract liabilities3,061  8,892  
Total accounts payable and accrued expenses$24,788  $27,279  
 September 30,
2019
 December 31,
2018
Accounts payable$4,353,117
 $4,481,544
Capitation payable2,603,636
 300,000
Subcontractor IPA risk pool payable3,171,030
 2,532,750
Professional fees3,523,226
 2,251,741
Due to related parties482,552
 1,488,313
Accrued compensation4,427,951
 4,996,906
Contract liabilities16,978,405
 9,024,235
    
 $35,539,917
 $25,075,489

8. Medical Liabilities
8.Medical Liabilities
The Company’s medical liabilities consisted of the following:following (in thousands):
June 30,
2020
June 30,
2019
Medical liabilities, beginning of period$58,725  $33,642  
Components of medical care costs related to claims incurred:
Current period165,571  93,833  
Prior periods233  2,688  
Total medical care costs165,804  96,521  
Payments for medical care costs related to claims incurred:
Current period(97,112) (60,440) 
Prior periods(57,470) (39,744) 
Total paid(154,582) (100,184) 
Acquired from Alpha Care—  13,120  
Adjustments326  (156) 
Medical liabilities, end of period$70,273  $42,943  

33

 September 30,
2019
 December 31,
2018
Balance, beginning of period$33,641,701
 $63,972,318
Acquired (see Note 3)26,404,372
 
Claims paid for previous period(49,164,084) (36,549,348)
Incurred health care costs178,472,645
 209,002,961
Claims paid for current period(135,580,214) (167,537,480)
Payment to CMS based on APAACO 2017 year settlement
 (34,464,826)
Adjustments45,227
 (781,924)
    
Balance, end of period$53,819,647
 $33,641,701
9. Credit Facility, Bank Loan and Lines of Credit
9.Credit Facility, Bank Loan and Lines of Credit
Credit Facility
The Company'sCompany’s credit facility consisted of the following:following (in thousands):
June 30, 2020
Term loan A$185,250 
Revolver loan60,000 
Total debt245,250 
Less: Current portion of debt(9,500)
Less: Unamortized financing costs(5,295)
Long-term debt$230,455 
 September 30, 2019
  
Term loan A$190,000,000
Revolver loan60,000,000
Total debt250,000,000
  
Less: Current portion of debt(9,500,000)
Less: Unamortized financing costs(6,350,937)
  
Long-term debt$234,149,063

The following table presents scheduled maturitiesFuture commitments of the Company'sCompany’s credit facility is to be as of September 30, 2019follows for the years ending December 31 (in thousands):

Amount
Amount
2019 (excluding the nine months ended September 30, 2019)$2,375,000
20209,500,000
2020 (excluding the six months ended June 30, 2020)2020 (excluding the six months ended June 30, 2020)$7,125  
202110,687,500
202110,688  
202214,250,000
202214,250  
202315,437,500
202315,437  
Thereafter197,750,000
20242024197,750  
 
Total$250,000,000
Total$245,250  
Credit Agreement
OnIn September 11, 2019, the Company entered into a secured credit agreement (the “Credit Agreement”Agreement,” and the credit facility thereunder, the "Credit Facility") with Truist Bank (formerly known as SunTrust Bank,Bank), in its capacity as administrative agent for the lenders (in such capacity, the “Agent”), as a lender, an issuer of letters of credit and as swingline lender, and Preferred Bank, JPMorgan Chase Bank, N.A., MUFG Union Bank, N.A., Royal Bank of Canada, Fifth Third Bank and City National Bank, as lenders (the “Lenders”). In connection with the closing of the Credit Agreement, the Company, its subsidiary, NMM, and the Agent entered into a Guaranty and Security Agreement (the “Guaranty and Security Agreement”), pursuant to which, among other things, NMM guaranteed the obligations of the Company under the Credit Agreement.
The Credit Agreement provides for a five-year revolving credit facility to the Company of $100.0 million ("(“Revolver Loan"Loan”), which includes a letter of credit subfacility of up to $25.0 million. The Credit Agreement also provides for a term loan of $190.0 million, ("(“Term Loan A"A”). The unpaid principal amount of the term loan is payable in quarterly installments on the last day of each fiscal quarter commencing on December 31, 2019. The principal payment for each of the first eight fiscal quarters is $2.4 million, for the following eight fiscal quarters thereafter is $3.6 million and for the following three fiscal quarters thereafter is $4.8 million. The remaining principal payment on the term loan is due on September 11, 2024.
The proceeds of the term loan and up to $60.0 million of the revolving credit facility may bewere used to (i) finance a portion of the $545.0 million loan made by the Company to AP-AMH Medical Corporation, a California professional medical corporation (“AP-AMH”), concurrently with the closing of the Credit Agreement (the “AP-AMH Loan”) as described in the May 13, 2019, Current Report and the August 29, 2019, Current Report,Loan, (ii) refinance certain indebtedness of the Company and its subsidiaries and, indirectly, APC, (iii) pay transaction costs and expenses arising in connection with the Credit Agreement, the AP-AMH Loan and certain other related transactions and (iv) provide for working capital, capital expenditures and other general corporate purposes. The remainder of the revolving credit facility will be used to finance future acquisitions and investments and to provide for working capital needs, capital expenditures and other general corporate purposes.
The Company is required to pay an annual facility fee of 0.20% to 0.35% on the available commitments under the Credit Agreement, regardless of usage, with the applicable fee determined on a quarterly basis based on the Company’s leverage ratio. The Company is also required to pay customary fees as specified in a separate fee agreement between the Company and SunTrust Robinson Humphrey, Inc., the lead arranger of the Credit Agreement.
34

Amounts borrowed under the Credit Agreement will bear interest at an annual rate equal to either, at the Company’s option, (a) the rate for Eurocurrency deposits for the corresponding deposits of U.S. dollars appearing on Reuters Screen LIBOR01 Page (“LIBOR”), adjusted for any reserve requirement in effect, plus a spread of frombetween 2.00% toand 3.00%, as determined on a quarterly basis based on the Company’s leverage ratio, or (b) a base rate, plus a spread ofbetween 1.00% toand 2.00%, as determined on a quarterly basis based on the Company’s leverage ratio. As of June 30, 2020, the interest rate on Term Loan A and Revolver Loan was 3.57% and 3.24%, respectively. The base rate is defined in a manner such that it will not be less than LIBOR. The Company will pay fees for standby letters of credit at an annual rate equal toof between 2.00% toand 3.00%, as determined on a quarterly basis based on the Company’s leverage ratio, plus facing fees and standard fees payable to the issuing bank on the respective letter of credit. Loans outstanding under the Credit Agreement may be prepaid at any time without penalty, except for LIBOR breakage costs and expenses. If LIBOR ceases to be reported, the Credit Agreement requires the Company and the Agent to endeavor to establish a commercially reasonable alternative rate of interest and until they are able to do so, all borrowings must be at the base rate.
The Credit Agreement requires the Company and its subsidiaries to comply with various affirmative covenants, including, without limitation, furnishing updated financial and other information, preserving existence and entitlements, maintaining properties and insurance, complying with laws, maintaining books and records, requiring any new domestic subsidiary meeting a materiality threshold specified in the Credit Agreement to become a guarantor thereunder and paying obligations. The Credit Agreement requires the Company and its subsidiaries to comply with, and to use commercially reasonable efforts to the extent permitted by

law to cause certain material associated practices of the Company, including APC, to comply with, restrictions on liens, indebtedness and investments (including restrictions on acquisitions by the Company), subject to specified exceptions. The Credit Agreement also contains various other negative covenants binding the Company and its subsidiaries, including, without limitation, restrictions on fundamental changes, dividends and distributions, sales and leasebacks, transactions with affiliates, burdensome agreements, use of proceeds, maintenance of business, amendments of organizational documents, accounting changes and prepayments and modifications of subordinated debt.
The Credit Agreement requires the Company to comply with two2 key financial ratios, each calculated on a consolidated basis. The Company must maintain a maximum consolidated leverage ratio of not greater than 3.75 to 1.00 as of the last day of each fiscal quarter. The maximum consolidated leverage ratio decreases by 0.25 each year, until it is reduced to 3.00 to 1.00 for each fiscal quarter ending after September 30, 2022. The Company must maintain a minimum consolidated interest coverage ratio of not less than 3.25 to 1.00 as of the last day of each fiscal quarter. As of SeptemberJune 30, 2019,2020, the Company was in compliance with the covenants relating to its credit facility.
Pursuant to the Guaranty and Security Agreement, the Company and NMM have granted the Lenders a security interest in all of their assets, including, without limitation, all stock and other equity issued by their subsidiaries (including NMM) and all rights with respect to the AP-AMH Loan. The Guaranty and Security Agreement requires the Company and NMM to comply with various affirmative and negative covenants, including, without limitation, covenants relating to maintaining perfected security interests, providing information and documentation to the Agent, complying with contractual obligations relating to the collateral, restricting the sale and issuance of securities by their respective subsidiaries and providing the Agent access to the collateral.
The Credit Agreement contains events of default, including, without limitation, failure to make a payment when due, default on various covenants in the Credit Agreement, breach of representations or warranties, cross-default on other material indebtedness, bankruptcy or insolvency, occurrence of certain judgments and certain events under the Employee Retirement Income Security Act of 1974 aggregating more than $10.0 million, invalidity of the loan documents, any lien under the Guaranty and Security Agreement ceasing to be valid and perfected, any change in control, as defined in the Credit Agreement, an event of default under the AP-AMH Loan, failure by APC to pay dividends in cash for any period of two consecutive fiscal quarters, failure by AP-AMH to pay cash interest to the Company, or if any modification is made to the Certificate of Determination or the Special Purpose Shareholder Agreement that directly or indirectly restricts, conditions, impairs, reduces or otherwise limits the payment of the Series A Preferred dividend by APC to AP-AMH. In addition, it will constitute an event of default under the Credit Agreement if APC uses all or any portion of the consideration received by APC from AP-AMH on account of AP-AMH’s purchase of Series A Preferred Stock for any purpose other than certain specific approved uses described in the following sentence, unless not less than 50.01% of all holders of common stock of APC at such time approve such use; provided that APC may use up to $50.0 million in the aggregate of such consideration for any purpose without any requirement to obtain such approval of the holders of common stock of APC. The approved uses include (i) any permitted investment, (ii) any dividend or distribution to the holders of the common stock of APC, (iii) any repurchase of common stock of APC, (iv) paying taxes relating to or arising from certain assets and transactions, or (v) funding losses, deficits or working capital support on account of certain non-healthcare assets in an amount not to exceed $125.0 million. If any event of default occurs and is continuing under the Credit Agreement, the Lenders may terminate their commitments, and may require the Company and its guarantors to repay outstanding debt and/or to provide a cash deposit as additional security for outstanding letters of credit. In
35

addition, the Agent, on behalf of the Lenders, may pursue remedies under the Guaranty and Security Agreement, including, without limitation, transferring pledged securities of the Company’s subsidiaries in the name of the Agent and exercising all rights with respect thereto (including the right to vote and to receive dividends), collect on pledged accounts, instruments and other receivables (including the AP-AMH Loan), and all other rights provided by law or under the loan documents and the AP-AMH Loan.
In the ordinary course of business, certain of the Lenders under the Credit Agreement and their affiliates have provided to the Company and its subsidiaries and the associated practices, and may in the future provide, (i) investment banking, commercial banking (including pursuant to certain existing business loan and credit agreements being terminated in connection with entering into the Credit Agreement), cash management, foreign exchange or other financial services, and (ii) services as a bond trustee and other trust and fiduciary services, for which they have received compensation and may receive compensation in the future.


Deferred Financing Costs


TheIn September 2019, the Company recorded deferred financing costs of $6.4$6.5 million related to the issuance of the Credit Facility. This amount was recorded as a direct reduction of the carrying amount of the related debt liability. The deferred financing costs will be amortized over the life of the Credit Facility using the effective interest rate method.


Effective Interest Rate
 

The Company’s average effective interest rate on its total debt during the six months ended June 30, 2020 and 2019, was 3.93% and 4.71%, respectively. Interest expense in the consolidated statements of income included amortization of deferred debt issuance costs for the three and ninesix months ended SeptemberJune 30, 2020 and 2019, was 1.02%of $0.3 million and 0.56%,$0, respectively, and $0.7 million and $0, respectively.
Bank Loan
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
NMM Business Loan
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, 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”rate,” plus 0.125%, or 5.125% as of September 30, 2019 and 5.625% as of December 31, 2018. The loan was guaranteed by Apollo Medical Holdings, Inc. and is collateralized by substantially all of the assets of NMM. The amounts outstanding as of June 30, 2019, of $5.0 million was fully repaid on September 11, 2019.
On September 5, 2018, NMM entered into a non-revolving line of credit agreement with Preferred Bank, which provides for loan availability of up to $20.0 million with a maturity date of September 5, 2019. This credit facility was subsequently amended on April 17, 2019, and July 29, 2019, to reduce the loan availability from $20.0 million to $16.0 million and from $16.0 million to $2.2 million, respectively. The interest rate is based on the Wall Street Journal “prime rate”rate,” plus 0.125%, or 5.125%3.375% as of SeptemberJune 30, 20192020, and 5.625%4.875% as of December 31, 2018.2019. The line of credit is guaranteed by Apollo Medical Holdings, Inc. and is collateralized by substantially all assets of NMM. NMM obtained this line of credit to finance potential acquisitions. Each drawdown from the line of credit is converted into a five-year term loan with monthly principal payments, plus interest based on a five-year amortization schedule.
On September 11, 2019, the NMM Business Loan Agreement, dated as of June 14, 2018, between NMM and Preferred Bank, as amended, and the Line of Credit Agreement, dated as of September 5, 2018, between NMM and Preferred Bank, as amended, waswere terminated in connection with the closing of the Credit Facility.credit facility. Certain letters of credit issued by Preferred Bank under the Line of Credit Agreement waswere terminated and reissued under the Credit Agreement. TheseAs of June 30, 2020, outstanding letters of credit totaled $14.8 million as of September 30, 2019 and the Company has $10.2 million available under the revolving credit facility.facility for letters of credit.
36

APC Business Loan
On June 14, 2018, APC amended its promissory note agreement with Preferred Bank, which provides for loan availability of up to $10.0 million with a maturity date of June 22, 2020. This credit facility was subsequently amended on April 17, 2019, and June 11, 2019, to increase the loan availability from $10.0 million to $40.0 million and extend the maturity date through December 31, 2020. On August 1, 2019, and September 10, 2019, this credit facility was further amended to increase loan availability from $40.0 million to $43.8 million, and decrease loan availability from $43.8 million to $4.1 million, respectively. This decrease further limited the purpose of the indebtedness under APC Business Loan Agreement to the issuance of standby letters of credit, and added as a permitted lien the security interest in all of its assets granted by APC in favor of NMM under a Security Agreement dated on or about September 11, 2019, securing APC’s obligations to NMM under, and as required pursuant to, that certain Management Services Agreementthe APC management services agreement dated as of July 1, 1999, as amended. The interest rate is based on the Wall Street Journal “prime rate”rate,” plus 0.125%, or 5.125%3.375% and 5.625%4.875% as of SeptemberJune 30, 20192020, and December 31, 2018,2019, respectively.
In May 2019, the Company drew down $39.6 million for capital to acquire Alpha Care. On September 11, 2019 in connection with the closingAs of the APC transaction (see Note 1) the outstanding amount was fully repaid.
No amounts were outstanding under the APC Business Loan Agreement as of SeptemberJune 30, 20192020 and December 31, 2018. As of September 30, 2019, and December 31, 2018,there was 0 availability under this line of credit was $0.0 million and $9.7 million, respectively.credit.
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 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. As of September 30, 2019, CMS has released the Company from this obligation.
On October 2, 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, 20192020, and is automatically extended without amendment for additional one - yearone-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. This standby letter of credit was subsequently amended on August 14, 2019, to increase amount from $6.6 million to $14.8 million and extended expiration date on December 31, 2020, with all other terms and conditions remain unchanged. In connection with the closing of the Credit Facility, this letter of credit was terminated and reissued under the Credit Agreement.
APC established irrevocable standby letters of credit with Preferred Bank under the APC Business Loan Agreement 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.
Alpha Care established irrevocable standby letters of credit with Preferred Bank under the APC Business Loan Agreement for a total of $3.8 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.
10.Mezzanine and Stockholders’ Equity

10.Mezzanine and Stockholders’ Equity
Mezzanine
Pursuant toAs the shareholder agreements that APC has entered into with its shareholders, in the eventredemption feature (see Note 2) of certain disqualifying events specified in the agreements (e.g., the shareholder's death, disability or retirement from the practice of medicine or breach of physician or other agreements with APC), APC has the option to purchase the shares of APC capital stock held by such shareholder for a purchase price specified therein. As APC's shares of capital stock are redeemable upon the occurrence of events that areis not solely within APC'sthe control suchof APC, shares arethe equity of APC does not qualify as permanent equity and has been classified as noncontrolling interest in APC as mezzanine or temporary equity rather than as permanent equity. Accordingly, the Company recognizes noncontrolling interests in APC as mezzanine equity in the condensed consolidated financial statements. APC’s shares are not redeemable and it is not probable that the shares will become redeemable as of SeptemberJune 30, 20192020 and December 31, 2018.
On December 18, 2018, the Company entered into a settlement agreement and mutual release with former APCN-ACO, Inc. 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.2019.
Stockholders’ Equity

As of the date of this Report, 480,212June 30, 2020, 302,732 holdback shares have not been issued to certain former NMM shareholders who were NMM shareholders at the time of closing of the Merger,merger between NMM and ApolloMed in December 2017 (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.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.
37

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 thousands)
Shares 
Weighted
Average
Exercise Price
 
Weighted
Average
Remaining
Contractual
Term
(Years)
 
Aggregate
Intrinsic
Value
(in millions)
Options outstanding at January 1, 2019647,240
 $5.62
 4.13
 $9.2
Options outstanding at January 1, 2020Options outstanding at January 1, 2020607,346  $9.22  3.42$5,600  
Options granted123,378
 17.80
 
 
Options granted11,742  18.41  —  —  
Options exercised(203,524) 5.77
 
 2.4
Options exercised(120,000) 2.58  —  1,800  
Options forfeited
 
 
 
Options forfeited(12,228) 17.57  —  —  
       
Options outstanding at September 30, 2019567,094
 $8.22
 3.60
 $5.4
Options outstanding at June 30, 2020Options outstanding at June 30, 2020486,860  $10.86  3.70$2,900  
       
Options exercisable at September 30, 2019466,216
 $5.07
 2.74
 $5.3
Options exercisable at June 30, 2020Options exercisable at June 30, 2020380,894  $7.11  2.74$3,000  
During the ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, stock options were exercised for 203,524120,000 and 366,454111,000 shares, respectively, of the Company’s common stock, which resulted in proceeds of approximately $1.2$0.3 million and $1.5$0.5 million, respectively. The exercise price rangeranged from $1.50$2.10 to $10.00$5.00 per share for the exercises during the ninesix months ended SeptemberJune 30, 20192020, and ranged from $0.01$1.50 to $10.00$5.79 per share for the exercises during the ninesix months ended SeptemberJune 30, 2018.2019.
During the ninesix months ended SeptemberJune 30, 20182020 and 2019, 0 stock options were exercised pursuant to the cashless exercise provision of the option agreement, with respect to 60,536 shares of the Company’s common stock, which resulted in the Company issuing 47,576 net shares.provision.
During the ninesix months ended SeptemberJune 30, 2019,2020, the Company granted 45,000 and 78,378 five year11,742 stock options with a vesting period of five-years to certain ApolloMed board members and executives, with an exercise price of $18.11 and $17.62, respectively,$18.41, which were recognized at fair value, as determined using the Black-Scholes option pricing model and the following assumptions:
June 30, 2020Board Members
Expected term3.0 years
Expected volatility90.01 %
Risk-free interest rate1.43 %
Market value of common stock$10.56 
Annual dividend yield— %
Forfeiture rate— %
September 30, 2019Board Members Executives
Expected Term3.0 years
 4.0 years
Expected volatility100.27% 91.04%
Risk-free interest rate2.51% 1.55%
Market value of common stock$18.11
 $17.62
Annual dividend yield% %
Forfeiture rate0% 0%
Restricted Stock Awards
The Company grants restricted stock awards to employees which are earned based on service conditions. The grant date fair value of the restricted stock awards is that day’s closing market price of the Company’s common stock. During the six months ended June 30, 2020, the Company granted restricted stock awards totaling 97,447 shares with a weighted average grant date fair value of $17.58. The grant date fair value of the restricted stock was $1.6 million to be recognized on a straight-line basis over the awards’ vesting period of three years.
During the three and ninesix months ended SeptemberJune 30, 2019,2020, the Company recorded approximately $0.1$0.9 million and $0.4$1.6 million of share-based compensation expense associated with the issuance of restricted shares of common stock and vesting of stock options which is included in Generalgeneral and administrative expenses in the accompanying condensed consolidated statementstatements of income, respectively.

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, 2019853,800
 $0.167
 0.75
 $0.5
Options granted
 
 
 
Options exercised
 
 
 
Options expired/forfeited
 
 
 
        
Options outstanding and exercisable at September 30, 2019853,800
 $0.167
 0.00
 $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 September 30, 2019.
Share-based Unrecognized compensation expense related to option awards granted to primary care physicians to purchase sharestotal share-based payments outstanding as of APC’s common stock, are recognized over their respective vesting periods, and consistedJune 30, 2020, was $3.8 million.
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 Three Months Ended
September 30,
 2019 2018
Share-based compensation expense:   
    
General and administrative$202,382
 $202,382
    
 $202,382
 $202,382

 Nine Months Ended
September 30,
 2019 2018
Share-based compensation expense:   
    
General and administrative$607,146
 $607,146
    
 $607,146
 $607,146
Restricted Stock Awards

During the three and nine months ended September 30, 2019, the Company granted restricted stock awards totaling 117,766 shares to certain executives which are earned based on service conditions. The grant date fair value is that day's closing market price of the Company's common stock. The grant date fair value of the restricted stock was $2.1 million to be recognized on a straight-line basis over the awards' vesting period of three 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 thousands)
Warrants outstanding at January 1, 20203,154,590  $9.96  2.01$26,700  
Warrants granted—  —  —  —  
Warrants exercised(273,900) 9.32  —  2,000  
Warrants expired/forfeited—  —  —  —  
Warrants outstanding at June 30, 20202,880,690  $10.02  1.61$18,700  
 Shares 
Weighted
Average
Exercise Price
 
Weighted
Average
Remaining
Contractual
Term
(Years)
 
Aggregate
Intrinsic
Value
(in millions)
Warrants outstanding at January 1, 20193,331,995
 $9.93
 2.97
 $33.1
Warrants granted
 
 
 
Warrants exercised(133,221) 9.21
 
 1.4
Warrants expired/forfeited
 
 
 
        
Warrants outstanding at September 30, 20193,198,774
 $9.96
 2.26
 $24.5
Exercise Price Per
Share
 Warrants
Outstanding
 
Weighted
Average
Remaining
Contractual Life
 
Warrants
Exercisable
 
Weighted
Average
Exercise Price
Per
Share
$9.00
 971,165
 1.04 971,165
 $9.00
10.00
 1,399,667
 2.55 1,399,667
 10.00
11.00
 827,942
 3.19 827,942
 11.00
         
$ 9.00 –11.00
 3,198,774
 2.26 3,198,774
 $9.96
Exercise Price Per ShareWarrants
Outstanding
Weighted
Average
Remaining
Contractual Life
Warrants
Exercisable
Weighted
Average
Exercise Price
Per Share
$9.00 754,870 0.29754,870 $9.00 
10.00 1,313,345 1.851,313,345 10.00 
11.00 812,475 2.44812,475 11.00 
$ $ 9.00 –11.002,880,690 1.612,880,690 $10.02 
During the ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, common stock warrants were exercised for 133,221273,900 and 268,66341,624 shares, respectively, of the Company’s common stock, which resulted in proceeds of approximately $1.2$2.6 million and $2.1$0.4 million, respectively. The exercise price ranged from $9.00 to $11.00 per share for the exercises during the ninesix months ended SeptemberJune 30, 2020 and 2019, and $4.00 to $11.00 during the nine months ended September 30, 2018.respectively.
Treasury Stock
APC owned 16,790,57617,307,214 and 1,682,11017,290,317 shares of ApolloMed’s common stock as of SeptemberJune 30, 20192020 and December 31, 2018,2019, 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. Pursuantpurposes (see Note 1).

During the year ended December 31, 2019, APC established a brokerage account to invest excess capital in the closingequity market. The brokerage account is managed directly by an independent investment committee of the APC transaction (see Note 1)board of directors, from which Dr. Kenneth Sim and issuanceDr. Thomas Lam have been excluded. As of June 30, 2020, the Holdback Shares (see Note 14), 15,015,015brokerage account only held shares of ApolloMed totaling $7.6 million, and as such the ApolloMed shares purchased and 93,451 shares issued to APC, respectively, are treatedin the brokerage account have been recorded as treasury shares. The remaining treasury shares of 168,493 were repurchased from the former APCN-ACO, Inc. shareholders in 2018.
Dividends
During the ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, APC paid dividends of $59.7$29.6 million and $2.0$10.0 million, respectively.

During the ninesix months ended SeptemberJune 30, 2020 and 2019, CDSC paid dividends of $0.6 million and $1.2 million.million, respectively.
11.Commitments and Contingencies

11. 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
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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, Alpha Care and Accountable Health Care are required to comply with California DMHC regulations, 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 June 30, 2020 and December 31, 2019, APC, Alpha Care and Accountable Health Care were 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 equal to 2% of the Company'sCompany’s benchmark Medicare Part A and Part B expenditures. The Company has established an irrevocable standby letter of credit with Preferred Bank of $14.8$8.2 million and $6.6 million for the 20182019 and 20192018 performance years (see Note 9).
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 9).
Alpha Care established irrevocable standby letters of credit with a financial institution for a total of $3.8 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.terminated (see Note 9).
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,By stipulation and order dated April 28, 2020, ApolloMed and AMM disputewere dismissed without prejudice from the arbitration for lack of jurisdiction on the basis that neither of them were a party to any arbitration agreement with Prospect, subject, however, to Prospect reserving its rights against ApolloMed and AMM and tolling of applicable statute of limitation. MMG disputes the allegations and intendintends 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
40

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.
12.Related Party Transactions

12. 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(see Note 5), in the amount of $5.0 million. On June 28, 2018 and November 28, 2018, UCAP entered into two2 additional subordinated note receivable agreements with UCI in the amount of $2.5 million and $5.0 million, respectivelyrespectively. On April 30, 2020, the outstanding balance was fully repaid as part of UCAP's disposition of its 48.9% ownership interest in UCI to Bright (see Note 6).
During the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, NMM earned approximately $4.4$4.2 million and $6.1$5.2 million, respectively, and $12.9 million and $16.0$8.4 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 5).
During the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, APC paid approximately $0.7$0.4 million and $0.6 million, respectively, and $2.1$1.0 million and $1.9$1.4 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 5).
During the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, APC paid approximately $2.0$0.9 million and $1.7$1.8 million, respectively, and $5.8$2.6 million and $5.5$3.8 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 5).
During the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, APC paid approximately $0.1 million, respectively, and $0.2$0.1 million, 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 and nine months ended SeptemberJune 30, 20192020 and 2018,2019, APC paid an aggregate of approximately $6.7$9.0 million and $7.3$7.1 million, respectively, and $23.1which include approximately $3.0 million and $29.2$1.9 million, respectively, to shareholders who are also officers of APC. During the six months ended June 30, 2020 and 2019, APC paid an aggregate of approximately of $16.3 million and $16.4 million, respectively, to shareholders of APC for provider services, which include approximately $1.8$4.8 million and $2.4 million, respectively, and $6.9 million and $9.8$5.1 million, respectively, to shareholders who are also officers of APC.
During the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, NMM paid approximately $0.3 million, respectively and $0.8$0.5 million, respectively, to Medical Property Partners (“MPP”) for an office lease. MPP shares common ownership with certain board members of NMM.
During the three and ninesix months ended SeptemberJune 30, 2018, APC2020, NMM paid $0.1approximately $0.4 million and $0.2$0.7 million, respectively, to Tag-2 Medical Investment Group, LLC (“Tag-2”One MSO, Inc. ("One MSO") for an office lease. Tag-2 shares common ownershipOne MSO is indirectly 50% owned by Drs. Sim and Lam. As of June 30, 2020, the Company had $10.6 million of ROU assets and lease liabilities, respectively, related to its office lease with certain board membersOne MSO to be amortized over the remaining life of APC.

the lease.
During the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, the Company paid approximately $0.1 million, and $0.2 million, respectively, and $0.3$0.2 million, respectively, to Critical Quality Management CorpCorporation (“CQMC”) for an office lease. CQMC shares common ownership with certain board members of APC.
During the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, SCHC paid approximately $0.1 million, respectively, and $0.3$0.2 million, respectively, to Numen, LLC (“Numen”) for an office lease. Numen is owned by a shareholder of APC.
During As of June 30, 2020, the threeCompany had $1.4 million of ROU assets and nine months ended September 30, 2019, NMM paid approximately $0.3 million,lease liabilities, respectively, related to AchievaMed, Inc., for anits office lease with One MSO to be amortized over the remaining life of the lease. NMM has an investment in AchievaMed (see Note 5).
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 earned related to AHMC, HSMSO and Aurion Corporation:(in thousands):
41

Three Months Ended June 30,Six Months Ended June 30,
Three Months Ended September 30, Nine Months Ended September 30,2020201920202019
2019 2018 2019 2018
AHMC – Risk pool and Capitation$11,215,000
 $35,771,000
 $39,165,000
 $69,169,000
AHMC – Risk pool, capitation, claims payment, netAHMC – Risk pool, capitation, claims payment, net$6,057  $16,350  $18,056  $27,950  
HSMSO – Management fees, net(160,000) (1,311,000) (1,075,000) (2,786,000)HSMSO – Management fees, net(189) (265) (321) (915) 
Aurion – Management fees(76,000) (78,000) (232,000) (242,000)Aurion – Management fees(53) (100) (128) (200) 
       
Net total$10,979,000
 $34,382,000
 $37,858,000
 $66,141,000
Net total$5,815  $15,985  $17,607  $26,835  
The Company and AHMC hashave a risk sharing agreement with certain AHMC hospitals to share the surplus and deficits of each of the hospital pools. During the three and ninesix months ended SeptemberJune 30, 20192020 and 2018,2019, the Company has recognized risk pool revenue under this agreement of $11.0$10.2 million and $45.2$10.2 million, respectively, and $31.9$21.0 million and $71.8$25.0 million, respectively, for which $34.0$53.7 million and $44.2$40.4 million remain outstanding as of SeptemberJune 30, 20192020 and December 31, 2018,2019, respectively.

During the three and six months ended June 30, 2020 and 2019, NMM paid approximately $0 and $0.1 million, respectively, and $27,000 and $0.1 million, respectively, to ApolloMed board member, Matthew Mazdyasni, for consulting services.
In addition, affiliates wholly-ownedwholly owned by the Company’s officers, including our Co-CEO,the Company's Co-CEOs, Dr. Sim and Dr. Lam, are reported in the accompanying condensed consolidated statementstatements 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 partyrelated-party transactions.
For equity method investments, loans receivable and line of credits from related parties, see Notes 5, 6 and 9, respectively.
13.Income Taxes

13.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 fiscal 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. When this occurs, the income tax provision (benefit) is 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 overall effective tax rate from quarter to quarter.
As of SeptemberJune 30, 20192020, 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 Federalfederal consolidation rules, as realization of these assets is uncertain.
The Company’s effective tax rate for the three and ninesix months ended SeptemberJune 30, 20192020, differed from the U.S. federal statutory rate primarily due to state income taxes, income from flow through entities, nondeductible permanent items, and change in valuation allowance.

As of SeptemberJune 30, 2019,2020, 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, 20142015 through December 31, 20172018, and for the years ended December 31, 20152016 through December 31, 2017,2018, respectively. The Company does not anticipate material unrecognized tax benefits within the next 12 months.
On March 27, 2020, the Coronavirus Aid, Relief and Economic Security Act ("CARES Act") was signed into law. The CARES Act includes various income and payroll tax provisions that we are in the process of analyzing to determine the tax impacts.
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14.Earnings Per Share
However, we do not expect the benefits of the CARES Act to impact the Company’s annual estimated tax rate for the period June 30, 2020.

14. Earnings Per Share
Basic earnings 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 attributable to Apollo Medical Holdings, Inc.ApolloMed by the weighted average number of shares of the Company’s common stock issued and outstanding during such period. Diluted earnings 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 SeptemberJune 30, 20192020 and December 31, 20182019, APC held 16,790,57617,307,214 and 1,682,11017,290,317 shares of ApolloMed’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 June 30,20202019
Earnings per share – basic$0.20  $0.10  
Earnings per share – diluted$0.19  $0.09  
Weighted average shares of common stock outstanding – basic36,071,604  34,540,059  
Weighted average shares of common stock outstanding – diluted37,285,585  37,962,555  
Three Months Ended September 30, 2019 2018
Six Months Ended June 30,Six Months Ended June 30,20202019
Earnings per share – basic $0.11
 $0.28
Earnings per share – basic$0.31  $0.11  
Earnings per share – diluted $0.10
 $0.24
Earnings per share – diluted$0.30  $0.10  
Weighted average shares of common stock outstanding – basic 34,643,754
 32,917,007
Weighted average shares of common stock outstanding – basic36,040,936  34,518,461  
Weighted average shares of common stock outstanding – diluted 37,792,266
 38,387,700
Weighted average shares of common stock outstanding – diluted37,296,913  37,896,837  
Nine Months Ended September 30, 2019 2018
Earnings per share – basic $0.21
 $0.43
Earnings per share – diluted $0.20
 $0.37
Weighted average shares of common stock outstanding – basic 34,555,124
 32,672,793
Weighted average shares of common stock outstanding – diluted 37,816,698
 38,010,838

Below is a summary of the shares included in the diluted earnings per share computations:
Three Months Ended June 30,20202019
Weighted average shares of common stock outstanding – basic36,071,604  34,540,059  
10% shares held back pursuant to indemnification clause—  1,519,805  
Stock options169,402  363,593  
Warrants1,041,784  1,539,098  
Restricted stock awards2,795  —  
Weighted average shares of common stock outstanding – diluted37,285,585  37,962,555  
Six Months Ended June 30,20202019
Weighted average shares of common stock outstanding – basic36,040,936  34,518,461  
10% shares held back pursuant to indemnification clause—  1,519,805  
Stock options173,299  368,273  
Warrants1,076,802  1,490,298  
Restricted stock awards5,876  —  
Weighted average shares of common stock outstanding – diluted37,296,913  37,896,837  


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Three Months Ended September 30, 2019 2018
Weighted average shares of common stock outstanding – basic 34,643,754
 32,917,007
10% shares held back pursuant to indemnification clause 1,511,332
 3,039,609
Stock options 299,536
 648,724
Warrants 1,337,644
 1,782,360
Weighted average shares of common stock outstanding – diluted 37,792,266
 38,387,700
15. Variable Interest Entities (VIEs)


Nine Months Ended September 30, 2019 2018
Weighted average shares of common stock outstanding – basic 34,555,124
 32,672,793
10% shares held back pursuant to indemnification clause 1,511,332
 3,039,609
Stock options 307,665
 633,131
Warrants 1,442,577
 1,665,305
Weighted average shares of common stock outstanding – diluted 37,816,698
 38,010,838

15.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 its VIEs, including Alpha Care and Accountable Health Care, and to which the creditors of APC, including Alpha Care and Accountable Health Care, have no recourse to the Company, nor do creditors of the Company have recourse against the assets of APC, including Alpha Care and Accountable Health Care. 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 affiliates, which are eliminated upon consolidation with NMM, are included in the accompanying condensed consolidated balance sheets.

sheets (in thousands).
44

September 30,
2019
 December 31,
2018
June 30,
2020
December 31,
2019
Assets   Assets
   
Current assets   Current assets
Cash and cash equivalents$201,806,867
 $71,726,342
Cash and cash equivalents$113,790  $87,110  
Restricted cash20,150
 
Restricted cash—  75  
Investment in marketable securities1,087,197
 1,066,103
Investment in marketable securities117,611  123,948  
Receivables, net17,992,524
 3,904,586
Receivables, net15,687  9,300  
Receivables, net – related party36,046,032
 45,258,916
Receivables, net – related party55,889  42,976  
Other receivablesOther receivables734  744  
Prepaid expenses and other current assets5,557,928
 3,647,654
Prepaid expenses and other current assets7,752  7,403  
Loan receivable - related party, short term6,425,000
 
Loan receivableLoan receivable6,425  6,425  
Loan receivable – related partiesLoan receivable – related parties—  16,500  
Total current assets268,935,698
 125,603,601
Total current assets317,888  294,481  
   
Noncurrent assets   Noncurrent assets
Land, property and equipment, net9,698,849
 9,602,228
Land, property and equipment, net9,085  9,547  
Intangible assets, net91,539,651
 58,984,420
Intangible assets, net75,177  81,439  
Goodwill107,551,295
 56,213,450
Goodwill109,460  108,913  
Loans receivable – related parties12,500,000
 12,500,000
Investment in a privately held entity that does not report net asset value per share4,725,000
 4,725,000
Investment in affiliatesInvestment in affiliates285,569  318,315  
Investment in privately held entitiesInvestment in privately held entities36,584  1,615  
Investments in other entities – equity method35,840,977
 26,707,404
Investments in other entities – equity method26,864  28,427  
Restricted cash746,104
 745,470
Restricted cash746  746  
Right-of-use assets3,758,391
 
Operating lease right-of-use assetsOperating lease right-of-use assets7,017  4,751  
Other assets1,058,601
 839,085
Other assets20,750  1,057  
   
Total noncurrent assets267,418,868
 170,317,057
Total noncurrent assets571,252  554,810  
   
Total assets$536,354,566
 $295,920,658
Total assets$889,140  $849,291  
   
Current liabilities   Current liabilities
Accounts payable and accrued expenses$8,811,988
 $6,378,751
Accounts payable and accrued expenses$11,822  $11,187  
Fiduciary accounts payable1,734,142
 1,538,598
Fiduciary accounts payable1,853  2,027  
Medical liabilities48,759,183
 24,983,110
Medical liabilities47,304  49,019  
Income taxes payable1,393,492
 11,621,861
Income taxes payable42,211  4,530  
Amount due to affiliate26,859,007
 11,505,680
Amount due to affiliate21,533  28,058  
Bank loan
 40,257
Dividends payable271,279
 
Dividends payable431  271  
Lease liabilities837,984
 
Capital lease obligations101,741
 101,741
Finance lease liabilitiesFinance lease liabilities102  102  
Operating lease liabilitiesOperating lease liabilities1,319  1,088  
   
Total current liabilities88,768,816
 56,169,998
Total current liabilities126,575  96,282  
   
Noncurrent liabilities   Noncurrent liabilities
Lines of credit
 
Deferred tax liability23,765,062
 15,693,159
Deferred tax liability9,490  14,059  
Liability for unissued equity shares1,185,025
 1,185,025
Lease liabilities2,861,560
 
Capital lease obligations441,241
 517,261
Finance lease liabilities, net of current portionFinance lease liabilities, net of current portion355  416  
Operating lease liabilities, net of current portionOperating lease liabilities, net of current portion5,833  3,742  
   
Total noncurrent liabilities28,252,888
 17,395,445
Total noncurrent liabilities15,678  18,217  
   
Total liabilities$117,021,704
 $73,565,443
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Total liabilities$142,253  $114,499  
The assets of the Company’s other consolidated VIEs were not considered significant.

16.Leases

16. 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 SeptemberJune 30, 20192020 and December 31, 2018,2019, assets recorded under finance leases were $0.5$0.4 million and $0.6$0.5 million, respectively, and accumulated depreciation associated with finance leases was $0.2$0.3 million, respectively.
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:follows (in thousands):
Three Months Ended June 30,
20202019
Operating lease cost$1,446  $1,240  
Finance lease cost
Amortization of lease expense$35  $25  
Interest on lease liabilities  
Sublease income$(226) $(106) 
Total finance lease cost, net$1,259  $1,163  
Six Months Ended June 30,
20202019
Operating lease cost$3,388  $2,343  
Finance lease cost
Amortization of lease expense$61  $50  
Interest on lease liabilities  
Sublease income$(360) $(206) 
Total finance lease cost, net$3,096  $2,196  

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 Three Months Ended September 30, 2019 Nine Months Ended September 30, 2019
    
Operating lease cost$1,488,706
 $3,831,665
    
Finance lease cost   
Amortization of lease expense$25,530
 76,019
Interest on lease liabilities4,200
 13,170
    
Sublease income$(102,849) $(308,929)
    
Total finance lease cost, net$1,415,587
 $3,611,925

Other information related to leases was as follows:follows (in thousands):
Three Months Ended June 30,
20202019
Supplemental Cash Flows Information
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$1,333  $1,239  
Operating cash flows from finance leases  
Financing cash flows from finance leases35  25  
Right-of-use assets obtained in exchange for lease liabilities:
Operating leases2,907  6,441  
Six Months Ended June 30,
20202019
Supplemental Cash Flows Information
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases$2,880  $2,273  
Operating cash flows from finance leases  
Financing cash flows from finance leases61  50  
Right-of-use assets obtained in exchange for lease liabilities:
Operating leases7,652  15,417  
Six Months Ended June 30,
20202019
Weighted Average Remaining Lease Term
Operating leases7.06 years6.87 years
Finance leases4.17 years5.00 years
Weighted Average Discount Rate
Operating leases6.10 %6.18 %
Finance leases3.00 %3.00 %
47

 Three Months Ended September 30, 2019 Nine Months Ended September 30, 2019
Supplemental Cash Flows Information   
    
Cash paid for amounts included in the measurement of lease liabilities:   
Operating cash flows from operating leases$1,676,800
 $3,949,665
Operating cash flows from finance leases4,200
 13,170
Financing cash flows from finance leases25,530
 76,019
    
Right-of-use assets obtained in exchange for lease liabilities:   
Operating leases
 15,417,482
Finance leases
 
    
   Nine Months Ended September 30, 2019
Weighted Average Remaining Lease Term   
    
Operating leases  6.80 years
Finance leases  4.92 years
    
Weighted Average Discount Rate   
    
Operating leases  6.12%
Finance leases  3.00%
Future minimum lease payments under non-cancellable leases as of SeptemberJune 30, 2019 and December 31, 2018 were2020 is as follows:follows (in thousands):
September 30, 2019Operating Leases Finance Leases
2019 (excluding the nine months ended September 30, 2019)$956,587
 $29,730
20203,375,924
 118,920
20212,281,608
 118,920
20221,979,546
 118,920
20231,723,977
 118,920
Thereafter6,368,798
 79,278
    
Total future minimum lease payments16,686,440
 584,688
Less: imputed interest3,180,066
 41,706
Total lease liabilities13,506,374
 542,982
Less: current portion2,836,010
 101,741
Long-term lease liabilities$10,670,364
 $441,241

December 31, 2018Operating Leases Finance Leases
2019$2,848,000
 $119,000
20202,267,000
 119,000
June 30, 2020June 30, 2020Operating LeasesFinance Leases
2020 (excluding the six months ended June 30, 2020)2020 (excluding the six months ended June 30, 2020)$2,337  $59  
2021783,000
 119,000
20214,297  119  
2022487,000
 119,000
20223,529  119  
2023489,000
 119,000
20233,303  119  
202420242,940  79  
Thereafter243,000
 79,000
Thereafter9,459  —  
   
Total future minimum lease payments$7,117,000
 $674,000
Total future minimum lease payments25,865  495  
Less: imputed interestLess: imputed interest5,097  38  
Total lease liabilitiesTotal lease liabilities20,768  457  
Less: current portionLess: current portion3,350  102  
Long-term lease liabilitiesLong-term lease liabilities$17,418  $355  
As of SeptemberJune 30, 2019,2020, the Company does not have additional operating and finance leases that have not yet commenced.


ITEM 2.  MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
The following management’s discussion and analysis should be read in conjunction with the unaudited condensed consolidated financial statements and the notes thereto included in Part I, Item 1, “Financial Statements” of this Quarterly Report on Form 10-Q. In addition, reference is made to our audited consolidated financial statements and notes thereto and related Management’s Discussion and Analysis of Financial Condition and Results of Operations included in our Annual Report on Form 10-K for the year ended December 31, 2018,2019, filed with the U.S. Securities and Exchange Commission (“SEC”)SEC on March 18, 2019.16, 2020.
The following management’s discussion and analysis contain forward-looking statements that reflect our plans, estimates, and beliefs as discussed under “Forward-Looking Statements” at the beginning of this Quarterly Report on Form 10-Q. Our actual results could differ materially from those plans, estimates, and beliefs. Factors that could cause or contribute to these differences include those discussed below and elsewhere in this Quarterly Report on Form 10-Q as well as the factors discussed in Part I, Item 1A, “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2018.
In this section, “we,” “our,” “ours” and “us” refer to Apollo Medical Holdings, Inc. and its consolidated subsidiaries and affiliated entities, as appropriate, including its consolidated variable interest entities ("VIEs").

Overview
We, together with our affiliated physician groups and consolidated entities, are 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”),HMOs, with a small portion of our revenuerevenues coming from non-insured patients. We provide 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. Our physician network consists of primary care physicians, specialist physicians and hospitalists. We operate primarily through Apollo Medical Holdings, Inc. (“ApolloMed”)ApolloMed and the following subsidiaries: Network Medical Management (“NMM”), Apollo Medical Management, Inc. (“AMM”), APA ACO, Inc. (“APAACO”)NMM, AMM, APAACO and Apollo Care Connect, Inc. (“Apollo Care Connect”), and their consolidated entities, including consolidated variable interest entities (“VIE”).entities.
Through our next generation accountable care organization (“NGACO”)NGACO model and a network of independent practice associations (“IPAs”)IPAs with more than 6,0007,000 contracted physicians, which physician groups have agreements with various health plans, hospitals and other HMOs, we are, as of June 30, 2020, currently responsible for coordinating the care for over 1,000,000approximately 1.1 million patients in California.California as of June 30, 2020. These covered patients are comprised of managed care members whose health coverage is provided through their employers or who have acquired health coverage directly from a health plan or as a result of their eligibility for Medicaid or Medicare benefits. Our managed patients benefit from an integrated approach that places physicians at the center of patient care and utilizes sophisticated risk management techniques and clinical protocols to provide high-quality, cost effective care. To implement a patient-centered, physician-centric experience, we also have other integrated and synergistic operations, including (i) MSOs that provide management and other services to our affiliated IPAs, (ii) outpatient clinics and (iii) hospitalists that coordinate the care of patients in hospitals.
This Quarterly Report on Form 10-Q contains forward-looking statements within the meaning

48

Table of the federal securities laws. Statements contained in this Quarterly Report on Form 10-Q that are not historical facts are forward-looking statements that the Company intends to be covered by the safe harbor provisions for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995. Statements that are predictive in nature, that depend on or refer to future events or conditions, or that include words such as “anticipates,” “believes,” “could,” “estimates,” “expects,” “intends,” “may,” “plans,” “potential,” “predicts,” “projects,” “should,” “will,” “would,” and similar expressions are forward-looking statements. These forward-looking statements include, but are not limited to statements regarding: our liquidity, including cash flows from operations and as payments under the $545.0 million loan we made to AP-AMH Medical Corporation; accounting treatment; net income; and future contractual obligations; and our outlook regarding our NGACO, and our strategic transactions. These forward-looking statements are subject to risks and uncertainties that could cause actual results and events to differ materially from those included in forward-looking statements. Factors that might cause or contribute to such differences include, but are not limited to, those discussed in our Annual Report on Form 10-K, for the year ended December 31, 2018 filed with the Securities and Exchange Commission (“SEC”) on March 18, 2019, in particular the risk factors discussed under the heading “Risk Factors” in Part I, Item IA. We assume no obligation to revise or publicly release any revision to any forward-looking statements contained in this Quarterly Report on Form 10-Q, unless required by law.Contents

Recent Developments
The following describes certain recent developments that are important to understanding our overall results of operations and financial condition.
Acquisitions
On August 30, 2019, Allied Physicians of California, a Professional Medical Corporation d.b.a. Allied Pacific of California (“APC”) and APC-LSMA Designated Shareholder Medical Corporation (“APC-LSMA”) have acquired all of the outstanding shares of capital stock in Accountable Health Care IPA, a Professional Medical Corporation ("Accountable Health Care"). In connection with the settlement of a dispute with Dr. Jayatilaka and Accountable Health Care, APC-LSMA acquired all shares of Accountable Health Care's capital stock held by Dr. Jayatilaka (comprising 75% of the outstanding shares of Accountable Health Care capital stock) in exchange for a cash payment of $7.3 million and assumption of all assets and liabilities of Accountable Health Care. APC previously owned the remaining 25% of the outstanding shares of Accountable Health Care capital stock.
On September 10, 2019, APC and APC-LSMA purchased all of the shares of all shareholders of AMG, a professional medical corporation ("AMG") for $1.7 million. AMG is a network of family practice clinics operating out of three main locations in Southern California. AMG provides professional and post-acute care services to Medicare, Medi-Cal/Medicaid, and Commercial patients through its networks of doctors and nurse practitioners.
Closing of the APC Business Transactions

On September 11, 2019, the Company, AP-AMH, APC and NMM concurrently closed the series of inter-connected transactions (the “APC Transactions”) as agreed upon on May 10, 2019. The closing included the following events:
1.The Company loaned AP-AMH $545.0 million pursuant to a ten-year secured loan agreement. The loan will bear interest at a rate of 10% per annum simple interest, is not prepayable (except in certain limited circumstances), requires quarterly payments of interest only in arrears, and is secured by a first priority security interest in all of AP-AMH's assets, including the shares of APC Series A Preferred Stock to be purchased by AP-AMH. To the extent that AP-AMH is unable to make any interest payment when due because it has received dividends on the APC Series A Preferred Stock insufficient to pay in full such interest payment, then the outstanding principal amount of the loan will be increased by the amount of any such accrued but unpaid interest, and any such increased principal amounts will bear interest at the rate of 10.75% per annum simple interest.
2.AP-AMH purchased 1,000,000 shares of APC Series A Preferred Stock for total aggregate consideration of $545.0 million in a private placement. Under the terms of the APC Certificate of Determination of Preferences of Series A Preferred Stock (the "Certificate of Determination"), AP-AMH is entitled to receive preferential, cumulative dividends that accrue on a daily basis and that are equal to the sum of (i) APC's net income from Healthcare Services (as defined in the Certificate of Determination), plus (ii) any dividends received by APC from certain of APC's affiliated entities, less (iii) any Retained Amounts (as defined in the Certificate of Determination).
3.APC purchased 15,015,015 shares of the Company's common stock for total consideration of $300.0 million in private placement. In connection therewith, the Company granted APC certain registration rights with respect to the Company's common stock that APC purchased, and APC agreed that APC votes in excess of 9.99% of the Company's then outstanding shares will be voted by proxy given to the Company's management, and that those proxy holders will cast the excess votes in the same proportion as all other votes cast on any specific proposal coming before the Company's stockholders
4.The Company licensed to AP-AMH the right to use certain tradenames for certain specified purposes for a fee equal to a percentage of the aggregate gross revenues of AP-AMH. The license fee is payable out of any Series A Preferred Stock dividends received by AP-AMH from APC.
5.Through its subsidiary, NMM, the Company has agreed to provide certain administrative services to AP-AMH for a fee equal to a percentage of the aggregate gross revenues of AP-AMH. The administrative fee also is payable out of any APC Series A Preferred Stock dividends received by AP-AMH from APC.
Other
On September 29, 2019, the Company's Board of Directors appointed Matthew Mazdyasni as a board member and appointed Brandon Sim as the Company's interim Chief Technology Officer.

On September 30, 2019, the Company appointed Kenneth Sim, M.D. to serve as Co-Chief Executive Officer and Thomas Lam, M.D., M.P.H. to serve as President of the Company. Dr. Sim will continue to serve as the Company's Executive Chairman and Dr. Lam will continue to serve as its Co-Chief Executive Officer.

On October 2, 2019, the Company entered into a new MSA, effective January 1, 2020, to provide select management services, via a subcontract agreement, to an IPA. The IPA currently serves approximately 145,000 members in three main markets within Southern California; South Los Angeles, San Fernando Valley, and Antelope Valley. The majority of the members are enrolled in Medi-Cal, with members also enrolled in Medicare Advantage and Commercial health plans, and are supported by a network of hundreds of primary care physicians and nearly a thousand specialists.
Key Financial Measures and Indicators
Operating Revenues
Our revenue primarily consists of capitation revenue, risk pool settlements and incentives, NGACO All-Inclusive Population-Based Payments (“AIPBP”)AIPBP revenue, management fee income and fee-for-services (“FFS”)FFS revenue. The form of billing and related risk of collection for such services may vary by type of revenue and the customer.
Operating Expenses
Our largest expense is the patient care cost paid to contracted physicians, and the cost of providing management and administrative support services to our affiliated physician groups. These services include payroll, benefits, human resource services,providing utilization and case management, physician practice billing, revenue cycle services, physician practice management, administrative oversight, coding services, and other consulting services.


49

Results of Operations
Apollo Medical Holdings, Inc.
Consolidated Condensed Statements of Income
(In thousands)
(Unaudited)
For the Three Months Ended
June 30, 2020June 30, 2019$ Change% Change
Revenue
Capitation, net$140,949  $103,224  $37,725  37 %
Risk pool settlements and incentives12,003  11,191  812  %
Management fee income8,690  10,353  (1,663) (16)%
Fee-for-services, net2,270  3,878  (1,608) (41)%
Other income1,257  1,404  (147) (10)%
Total revenue165,169  130,050  35,119  27 %
Operating expenses
Cost of services136,079  101,363  34,716  34 %
General and administrative expenses11,556  11,818  (262) (2)%
Depreciation and amortization4,628  4,455  173  %
Provision for doubtful accounts—  (2,314) 2,314  (100)%
Total expenses152,263  115,322  36,941  32 %
Income from operations12,906  14,728  (1,822) (12)%
Other income
Income (loss) from equity method investments834  (42) 876  *
Gain on sale of equity method investments99,647  —  99,647  100 %
Interest expense(2,673) (311) (2,362) *
Interest income863  474  389  82 %
Other income1,282  24  1,258  *
Total other income, net99,953  145  99,808  *
Income before provision for income taxes112,859  14,873  97,986  *
Provision for income taxes31,858  4,209  27,649  *
Net income$81,001  $10,664  $70,337  *
Net income attributable to noncontrolling interests73,957  7,119  66,838  *
Net income attributable to ApolloMed$7,044  $3,545  $3,499  99 %

* Percentage change of over 500%
50

For the Three Months Ended    For the Six Months Ended
September 30, 2019 September 30, 2018 $ Change 
%
Change
June 30, 2020June 30, 2019$ Change% Change
Revenue       Revenue
Capitation, net$130,807,706
 $90,612,720
 $40,194,986
 44 %Capitation, net$281,370  $174,740  $106,630  61 %
Risk pool settlements and incentives11,355,069
 57,788,932
 (46,433,863) (80)%Risk pool settlements and incentives23,239  21,285  1,954  %
Management fee income8,517,586
 12,851,178
 (4,333,592) (34)%Management fee income17,505  19,349  (1,844) (10)%
Fee-for-services, net4,099,660
 4,723,809
 (624,149) (13)%Fee-for-services, net5,697  7,959  (2,262) (28)%
Other income1,280,203
 752,642
 527,561
 70 %Other income2,463  2,473  (10) — %
Total revenue156,060,224
 166,729,281
 (10,669,057) (6)%Total revenue330,274  225,806  104,468  46 %
Operating expenses       Operating expenses
Cost of services131,129,813
 96,268,804
 34,861,009
 36 %Cost of services280,283  184,795  95,488  52 %
General and administrative expenses7,949,814
 9,040,336
 (1,090,522) (12)%General and administrative expenses23,390  22,081  1,309  %
Depreciation and amortization4,920,429
 4,843,037
 77,392
 2 %Depreciation and amortization9,330  8,872  458  %
Impairment of intangibles1,994,000
 
 1,994,000
  %
Provision for doubtful accountsProvision for doubtful accounts—  (1,363) 1,363  (100)%
Total expenses145,994,056
 110,152,177
 35,841,879
 33 %Total expenses313,003  214,385  98,618  46 %
Income from operations10,066,168
 56,577,104
 (46,510,936) (82)%Income from operations17,271  11,421  5,850  51 %
Other income (expense)       Other income (expense)
Income (loss) from equity method investments2,053,730
 (4,215,056) 6,268,786
 (149)%Income (loss) from equity method investments2,888  (892) 3,780  *
Gain on sale of equity method investmentsGain on sale of equity method investments99,647  —  99,647  100 %
Interest expense(827,905) (178,318) (649,587) 364 %Interest expense(5,541) (522) (5,019) *
Interest income508,856
 418,449
 90,407
 22 %Interest income1,792  797  995  125 %
Other income2,620,485
 609,203
 2,011,282
 330 %Other income1,384  211  1,173  *
Total other income (expense), net4,355,166
 (3,365,722) 7,720,888
 (229)%Total other income (expense), net100,170  (406) 100,576  *
Income before provision for income taxes14,421,334
 53,211,382
 (38,790,048) (73)%Income before provision for income taxes117,441  11,015  106,426  *
Provision for income taxes3,682,472
 14,585,942
 (10,903,470) (75)%Provision for income taxes33,453  2,801  30,652  *
Net income$10,738,862
 $38,625,440
 $(27,886,578) (72)%Net income$83,988  $8,214  $75,774  *
       
Net income attributable to noncontrolling interests7,034,688
 29,519,043
 (22,484,355) (76)%Net income attributable to noncontrolling interests72,892  4,529  68,363  *
Net income attributable to Apollo Medical Holdings, Inc.$3,704,174
 $9,106,397
 $(5,402,223) (59)%
Net income attributable to ApolloMedNet income attributable to ApolloMed$11,096  $3,685  $7,411  201 %


 For the Nine Months Ended    
 September 30, 2019 September 30, 2018 $ Change 
%
Change
Revenue       
Capitation, net$305,548,176
 $266,834,186
 $38,713,990
 15 %
Risk pool settlements and incentives32,639,960
 89,641,885
 (57,001,925) (64)%
Management fee income27,866,805
 37,297,358
 (9,430,553) (25)%
Fee-for-services, net12,058,762
 15,524,149
 (3,465,387) (22)%
Other income3,753,258
 4,021,480
 (268,222) (7)%
Total revenue381,866,961
 413,319,058
 (31,452,097) (8)%
Operating expenses       
Cost of services315,925,388
 280,589,061
 35,336,327
 13 %
General and administrative expenses30,031,329
 31,481,810
 (1,450,481) (5)%
Depreciation and amortization13,792,581
 14,819,627
 (1,027,046) (7)%
Provision for bad debt(1,363,415) 
 (1,363,415)  %
Impairment of intangibles1,994,000
 
 1,994,000
  %
Total expenses360,379,883
 326,890,498
 33,489,385
 10 %
Income from operations21,487,078
 86,428,560
 (64,941,482) (75)%
Other income (expense)       
Income (loss) from equity method investments1,161,791
 (2,573,219) 3,735,010
 (145)%
Interest expense(1,349,933) (374,002) (975,931) 261 %
Interest income1,305,528
 1,180,990
 124,538
 11 %
Other income2,831,830
 884,948
 1,946,882
 220 %
Total other income (expense), net3,949,216
 (881,283) 4,830,499
 (548)%
Income before provision for income taxes25,436,294
 85,547,277
 (60,110,983) (70)%
Provision for income taxes6,483,630
 23,338,589
 (16,854,959) (72)%
Net income$18,952,664
 $62,208,688
 $(43,256,024) (70)%
        
Net income attributable to noncontrolling interests11,563,610
 48,277,734
 (36,714,124) (76)%
Net income attributable to Apollo Medical Holdings, Inc.$7,389,054
 $13,930,954
 $(6,541,900) (47)%

* Percentage change of over 500%
Net Income Attributable to Apollo Medical Holdings, Inc.ApolloMed
Our net income attributable to Apollo Medical Holdings, Inc.ApolloMed for the three months ended SeptemberJune 30, 20192020 was $3.7$7.0 million, as compared to net income attributable to ApolloMed of $9.1$3.5 million for the same period in 2018, a decrease2019, an increase of $5.4 million or 59%. The decrease in net income attributable to Apollo Medical Holdings, Inc. was primarily attributable to the decrease to revenue as discussed in the section below.$3.5 million.
Our net income attributable to Apollo Medical Holdings, Inc.ApolloMed for the ninesix months ended SeptemberJune 30, 20192020 was $7.4$11.1 million, as compared to net income attributable to ApolloMed of $13.9$3.7 million for the same period in 2018, a decrease2019, an increase of $6.5 million or 47%. $7.4 million.
The decreaseincrease in net income attributable to Apollo Medical Holdings, Inc.ApolloMed for the three and six months ended June 30, 2020 was primarily attributabledriven by the completion of a series of transactions with APC as further described in Note 1 to the decreaseour financial statements above, which resulted in preferred, cumulative dividends from APC being allocated to revenue as discussed in the section below.AP-AMH.
Physician Groups and Patients
As of SeptemberJune 30, 2020 and 2019, we managed a total of 13 and 2018, the total number11 groups of affiliated physician groups managed by us was 12 and 12 groups,physicians, respectively, and the total number of patients for whom we managed the delivery of healthcare services was approximately 1,000,0001.1 million and 1,039,859,1.0 million, respectively. The decreaseincrease was dueattributable to a management services agreement we entered with an independent practice association, Community Family Care Medical Group IPA, Inc. ("CFC"), which contributed 0.1 million new members and increased membership at the closure of an affiliatedother physician group on January 31, 2019 as their primary health plan cancelled their contract.groups we manage.
Revenue

51

Our revenue for the three months ended SeptemberJune 30, 20192020, was $156.1$165.2 million, as compared to $166.7$130.1 million for the three months ended SeptemberJune 30, 2018, a decrease2019, an increase of $10.6$35.1 million, or 6%27%. The decreaseincrease in revenue was primarily attributable to the following;following:
(i) Capitation revenuesrevenue increased by approximately $40.2$37.7 million primarily due to the acquisitionour acquisitions of Alpha Care as ofon May 31, 2019 and Accountable Health Care as ofon August 30, 2019, which contributed revenuesadditional revenue of approximately $34.5$20.7 million and $4.6$11.8 million, respectively, in addition to organic capitation revenue growth at APC of $2.5 million, for the three months ended SeptemberJune 30, 2019.2020. Further, APA ACO generated additional capitation revenue of approximately $2.7 million for the three months ended June 30, 2020 as compared to June 30, 2019 due to the delayed start of 2019 APA ACO performance year.
(ii) Risk pool revenue decreasedincreased by $46.4$0.8 million due to the refinement of the assumptions used to estimate the amount of net surplus expected to be received from the affiliated hospitals’ risk pools. Our estimated risk pool receivable is calculated based on reports received from our hospital partners and on management’s estimate of the Company’s portion of any estimated risk pool surpluses infor which payments have not been received. The actual risk pool surpluses are settled approximately 18 months later.
(iii) Management fee income decreased by $4.3$1.7 million mainly due to the acquisition of Accountable Health Care, which reduced management fee income by $2.2 million and a decrease in LMA's management fee of $1.0 million. This decrease was offset by management fee income of $1.7 million for the number of patients served by some of our affiliated physician groups, including an affiliated physician group that ceased operationsthree months ended June 30, 2020 generated from the management services agreement we entered into with CFC, which became effective on January 31, 2019 as their primary health plan canceled their contract.1, 2020.
(iv) Fee-for-service revenue decreased by $0.6$1.6 million due to strategic decisions in 2018 to wind down several medical groups affiliated with Apollo Medical Holdings, Inc. prior toreduced demand at our surgery centers and heart center as a result of the Merger. The operations of these medical groups, BAHA, AKM, and MMG, were not consistent with the Company’s future business plans.COVID-19 outbreak.
(v) Other income increaseddecreased by $0.5$0.1 million as a result of changes in the accrual ofdecreased revenue related to maternity supplemental payments.
Our revenue for the ninesix months ended SeptemberJune 30, 20192020 was $381.9$330.3 million, as compared to $413.3$225.8 million for the ninesix months ended SeptemberJune 30, 2018, a decrease2019, an increase of $31.4$104.5 million, or 8%46%. The decreaseincrease in revenue was primarily attributable to the following:
(i) Capitation revenuesrevenue increased by approximately $38.7$106.6 million primarily due to theour acquisitions of Alpha Care on May 31, 2019 and Accountable Health Care which were acquired as of May 31, 2019 andon August 30, 2019, respectively, andwhich contributed approximately $45.9 million and $4.6 million of revenue, respectively, for the nine month period ended September 30, 2019. This increase was offset by the delayed commencement by the Centers for Medicare & Medicaid Services ("CMS") of APAACO's 2019 Next Generation ACO performance year to April 1, 2019 which resulted in decreasedadditional revenue of approximately $11.8 million.$53.2 million and $24.3 million, respectively, in addition to organic capitation revenue growth at APC of $4.5 million, for the six months ended June 30, 2020. Further, APA ACO generated additional capitation revenue of approximately $24.6 million for the six months ended June 30, 2020 as compared June 30, 2019 due to the delayed start of the 2019 APA ACO performance year.
(ii) Risk pool revenue decreasedincreased by $57.0$2.0 million due to the refinement of the assumptions used to estimate the amount of net surplus expected to be received from the affiliated hospitals’ risk pools. Our estimated risk pool receivable is calculated based on reports received from our hospital partners and on management’s estimate of the Company’s portion of any estimated risk pool surpluses infor which payments have not been received. The actual risk pool surpluses are settled approximately 18 months later.
(iii) Management fee income decreased by $9.4$1.8 million mainly due to the acquisition of Accountable Health Care, which reduced management fee income by $4.2 million and a reduction in hospitalist stipend of $1.0 million. This decrease inwas offset by management fee income of $3.4 million for the number of patients served by some of our affiliated physician groups, including an affiliated physician group that ceased operationssix months ended June 30, 2020 generated from the management services agreement we entered into with CFC, which became effective on January 31, 2019 as their primary health plan canceled their contract.1, 2020.
(iv) Fee-for-service revenue decreased by $3.4$2.3 million due to strategic decisions in 2018 to wind down several medical groups affiliated with Apollo Medical Holdings, Inc. prior to the Merger. The operations of these medical groups, BAHA, AKM,reduced procedures performed at our surgery centers and MMG, were not consistent with the Company’s future business plans.
(v) Other income decreased by $0.3 millionheart center as a result of changes in the accrual of revenue related to maternity supplemental payments.COVID-19 outbreak.
Cost of Services
Expenses related to cost of services for the three months ended SeptemberJune 30, 20192020, were $131.1$136.1 million, as compared to $96.3$101.4 million for the same period in 2018,2019, an increase of $34.8$34.7 million, or 36%34%. The overall increase was due to a $37.6$32.8 million increase in medical claims, capitation and other health services expenses, primarily driven by the acquisitions of Alpha Care, and Accountable Health Care acquisitions, and AMG and a $1.9 million increase in management fee expense paidpayroll costs to support the prior MSO related to Alpha Care's transition, offset with a decrease in provider bonus paymentcontinued growth of $4.7 million.the business.

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Expenses related to cost of services for the ninesix months ended SeptemberJune 30, 20192020, were $315.9$280.3 million, as compared to $280.6$184.8 million for the same period in 2018,2019, an increase of $35.3$95.5 million, or 13%52%. The overall increase was due to a $34.9$99.3 million increase in medical claims, capitation and other health services expenses, primarily driven by the acquisition of Alpha Care, and Accountable Health Care acquisitions,and AMG, in addition to increased costs at APA ACO for the six month period ended June 30, 2020 as compared to the same period in 2019 due to the delayed start of the 2019 APA ACO performance year and a $2.8$4.2 million increase in management fee expense related to Alpha Care's transition, and an increase of $1.7 million in personnelpayroll costs to support the continued growth in depth and breadth of our operations. These increasesthe business. The increased costs were offset withby a net decrease of $8.0 million in provider bonus payment of $4.1 million.payments made to providers for the six months ended June 30, 2020 as compared to the bonus payments made to providers during the same period in 2019.
General and Administrative Expenses
General and administrative expenses for the three months ended SeptemberJune 30, 20192020, were $7.9$11.6 million, as compared to $9.0$11.8 million for the same period in 2018,2019, a decrease of $1.1$0.2 million, or 12%2%. The overall decrease is primarily due to fewer supplies required as COVID-19 outbreak caused a reduction in professional services costs of $2.0 million specific only to three months ended September 30, 2019. Net of this reduction, generalprocedures performed on site at the surgery centers and administrative expenses increased by $0.9 million from the continued growth in depth and breadth of our operations.heart centers.
General and administrative expenses for the ninesix months ended SeptemberJune 30, 20192020 were $30.0$23.4 million, as compared to $31.5$22.1 million for the same period in 2018, a decrease2019, an increase of $1.5$1.3 million, or 5%6%. The overall decreaseincrease is primarily due to a reduction in professional services costs of $2.0 million specific onlyincreased rent expense to three months ended September 30, 2019. Net of this reduction, general and administrative expenses increased by $0.5 million fromsupport the continued growth in depth and breadth of our operations.
Depreciation and Amortization
Depreciation and amortization expenseexpenses for the three and nine months ended SeptemberJune 30, 20192020 were $4.9$4.6 million and $13.8 million, respectively, as compared to $4.8$4.5 million and $14.8 million, respectively, for the same period in 2018.2019. This amount includes depreciation of property and equipment and the amortization of intangible assets.
Depreciation and amortization expenses for the six months ended June 30, 2020 were $9.3 million as compared to $8.9 million for the same period in 2019. This amount includes depreciation of property and equipment and the amortization of intangible assets.
Provision for Doubtful Accounts
For the ninethree and six months ended SeptemberJune 30, 2019, we released reserves related to certain management fees in the amount of $3.8approximately $2.3 million and $1.4 million, respectively, as collectability of the outstanding amount iswas no longer in doubt. These reserves were related to various preacquisition obligations of Accountable Health Care and were no longer necessary as a result of our acquisition. As such our provision for doubtful accounts was a negative $1.4 million for the nine months ended September 30, 2019, respectively.
Impairmentacquisition of Intangibles
For the three and nine months ended September 30, 2019, we impaired intangible assets totaling $2.0 million related to Medicare licenses obtained as part of the Merger. We will no longer utilize the licenses and as such will not receive future economic benefits.Accountable Health Care.
Income (Loss) from Equity Method Investments
Income from equity method investments for the three months ended SeptemberJune 30, 20192020, was $2.1$0.8 million, as compared to loss from equity method investments of $4.2 million$42,000 for the same period in 2018,2019, an increase of $6.3 million, or 149%.$0.9 million. The increase was primarily due to a $1.8 million gain recognized in our investment of Accountable Health Care and equity earnings from our investments in UCI DMG, and PMIOC of $0.9 million, offset with equity losses in our investments in LMA's IPA line of business, MWN, and 531 College LLC, of $0.6 million for the three months ended September 30, 2019 as compared to equity losses from our investment in UCI of $4.6 million offset with equity earnings from our investments LMA's IPA line of business, DMG, PASC, and PMIOC of $0.4 million in the same period in 2018.million.
Income from equity method investments for the ninesix months ended SeptemberJune 30, 20192020, was $1.2$2.9 million, as compared to loss from equity method investments of $2.6$0.9 million for the same period in 2018,2019, an increase of $3.8 million, or 145%.million. The increase was primarily due to equity earnings from our investments in UCI DMG, and PMIOC of $7.0$3.5 million and $0.1 million, respectively, offset by equity losses infrom our investments of Accountable Health Care,in LMA's IPA line of business, MWN,531 W. College, and 531 College LLC,DMG of $5.5$0.4 million, $0.2 million, and $0.1 million, respectively, for the six months ended June 30, 2020, as compared with losses from our investments in LMA's IPA line of business and Accountable Health Care of $2.4 million and $4.3 million, respectively, in the ninesix months ended SeptemberJune 30, 2019. In addition to the recognition of an impairment loss of $0.3 million related to our investment in PASC as we do not expect to recover our investment. This is compared to equityPASC. These losses in our investments of UCI and LMA's IPA line of business of $3.7 millionwere offset by equitywith earnings from our investments in UCI, DMG, PASC, and PMIOC of $1.1$5.5 million, in$0.4 million, and $0.2 million, respectively.
Gain on Sale of Equity Method Investments
Gain from equity method investments for the same period in 2018.three and six months ended June 30, 2020, was $99.6 million primarily due to the sale of UCI which closed on April 30, 2020.
Interest Expense

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Interest expense for the three months ended SeptemberJune 30, 20192020, was $0.8$2.7 million, as compared to $0.2$0.3 million for the same period in 2018,2019, an increase of $0.6 million, or 364%.$2.4 million. The increase was primarily due to the new credit facility we secured in September 2019 to fund growth, primarily through acquisitions.
Interest expense for ninethe six months ended SeptemberJune 30, 20192020, was $1.3$5.5 million, as compared to $0.4$0.5 million for the same period in 2018,2019, an increase of $0.9 million, or 261%.$5.0 million. The increase was primarily due to increased borrowings on our line of credits and the new credit facility we secured in September 2019 to fund growth, primarily through acquisitions.
Interest Income
Interest income for the three and ninesix months ended SeptemberJune 30, 20192020, was $0.5$0.9 million and $1.3$1.8 million, respectively, as compared to $0.4$0.5 million and $1.2$0.8 million, respectively, for the three and ninesix months ended SeptemberJune 30, 2018.2019. Interest income reflects interest earned on cash held in money market and certificate of deposit accounts and the interest from notes receivable.
Other Income
Other income for the three and ninesix months ended SeptemberJune 30, 20192020, was $2.6$1.3 million and $2.8$1.4 million respectively, as compared to $0.6 millionother income of $24,000 and $0.9$0.2 million, respectively, for the same periods in 2018. Increase2019. The increase in other income iswas primarily driven bydue to government grants received during the assumptionthree and six months ended June 30, 2020 of a loan receivable as a result of the Accountable Health Care acquisition.$0.9 million.
Provision for Income Tax (Benefit) Provision
Income tax expense was $3.7$31.9 million for the three months ended SeptemberJune 30, 2019,2020, as compared to $14.6a tax provision of $4.2 million for the same period in 2018.2019. The decreaseincrease in tax expense was due to decreasedincreased income in the three months ended SeptemberJune 30, 20192020, period as compared to the same period in 2018,2019, as described above.
Income tax expense was $6.5$33.5 million for the ninesix months ended SeptemberJune 30, 2019,2020, as compared to $23.3a tax provision of $2.8 million for the same period in 2018.2019. The decreaseincrease in tax expense was due to lower earningsincreased income in the ninesix months ended SeptemberJune 30, 20192020 period as compared to the same period in 2018,2019, as described above.
Net Income Attributable to Noncontrolling Interests
Net income attributable to noncontrolling interests was $7.0$74.0 million for the three months ended SeptemberJune 30, 20192020, compared to $29.5$7.1 million for the same period in 2018, a decrease2019, an increase of $22.5 million, or 76%.$66.9 million. The decreaseincrease was primarily due to a decreaseour sale of equity interests in risk pool revenue generatedUCI in April 2020, the gain from APC mainly attributable to the refinementwhich constitutes an excluded asset of the assumptions used to estimate the amount of net surplus expected to be received from the affiliated hospitals’ risk pools and the close of the series of transaction resulting in guaranteed dividends being allocated to ApolloMed and reducing noncontrolling interest by $1.6 million.APC.
Net income attributable to noncontrolling interests was $11.6$72.9 million for the ninesix months ended SeptemberJune 30, 2019,2020, compared to $48.3$4.5 million for the same period in 2018, a decrease2019, an increase of $36.7 million, or 76%. This decrease$68.4 million. The increase was primarily due to of sale of an excluded asset, UCI in April 2020 where the gain remains strictly with APC.

2020 Guidance
        Our stable, subscription-based revenue model allows us to maintain our previously disclosed 2020 guidance for total revenue and adjusted Earnings Before Interest, Taxes, Depreciation and Amortization (“EBITDA”).
        Our guidance for the year ending December 31, 2020, is as follows:
Maintain total revenue of between $665.0 million and $675.0 million,
Maintain net income of between $100.0 million and $110.0 million,
Maintain EBITDA of between $155.0 million and $167.0 million, and
Maintain adjusted EBITDA of between $75.0 million and $90.0 million.
        Refer to the "Guidance Reconciliation of Net Income to EBITDA and adjusted EBITDA" and "Use of Non-GAAP Financial Measures" for additional information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. Refer to our discussion of "Forward-Looking Statements" within this Quarterly Report on Form 10-Q.
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Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA (in thousands)
Year Ending
December 31, 2020
LowHigh
 Net income(1)
$100,000  $110,000  
     Depreciation and amortization18,000  20,000  
     Provision for income taxes30,000  31,000  
     Interest expense8,000  9,000  
     Interest income(1,000) (3,000) 
EBITDA(1)
155,000  167,000  
     Income from equity method investments (2)
(95,000) (94,000) 
     EBITDA adjustment for recently acquired IPAs15,000  17,000  
Adjusted EBITDA$75,000  $90,000  
(1) Net income and EBITDA includes the gain on sale of UCAP's 48.9% investment in UCI to Bright, which closed on April 30, 2020. UCAP is a decrease100% owned subsidiary of APC and its 48.9% investment in risk pool revenue generated fromUCI is an excluded asset and as such remained solely for the benefit of APC mainlyand its shareholders. As such, any proceeds or gain on sale has not affected the net income and adjusted EBITDA attributable to ApolloMed.

(2) Income from equity method investments is mainly attributed to the refinementsale of UCAP's 48.9% investment in UCI to Bright, which closed on April 30, 2020. UCAP is a 100% owned subsidiary of APC and its 48.9% investment in UCI is an excluded asset and as such remained solely for the benefit of APC and its shareholders. As such, any proceeds or gain on sale has not affected the net income and adjusted EBITDA attributable to ApolloMed.

Use of Non-GAAP Financial Measures
This Quarterly Report on Form 10-Q contains the non-GAAP financial measures EBITDA and adjusted EBITDA, of which the most directly comparable financial measure presented in accordance with GAAP is net (loss) income. These measures are not in accordance with, or an alternative to, U.S. generally accepted accounting principles, (“GAAP”), and may be different from other non-GAAP financial measures used by other companies. The Company uses adjusted EBITDA as a supplemental performance measure of our operations, for financial and operational decision-making, and as a supplemental means of evaluating period-to-period comparisons on a consistent basis. Adjusted EBITDA is calculated as earnings before interest, taxes, depreciation, and amortization, excluding income from equity method investments and other income earned that is not related to the Company's normal operations. Adjusted EBITDA also excludes the effect on EBITDA of certain IPAs we recently acquired.
The Company believes the presentation of these non-GAAP financial measures provides investors with relevant and useful information as it allows investors to evaluate the operating performance of the assumptions usedbusiness activities without having to estimateaccount for differences recognized because of non-core and non-recurring financial information. When GAAP financial measures are viewed in conjunction with non-GAAP financial measures, investors are provided with a more meaningful understanding of ApolloMed's ongoing operating performance. In addition, these non-GAAP financial measures are among those indicators the amount of net surplus expectedCompany uses as a basis for evaluating operational performance, allocating resources and planning and forecasting future periods. Non-GAAP financial measures are not intended to be received fromconsidered in isolation, or as a substitute for, GAAP financial measures. To the affiliated hospitals’ risk poolsextent this release contains historical or future non-GAAP financial measures, the Company has provided corresponding GAAP financial measures for comparative purposes. The reconciliation between certain GAAP and the closenon-GAAP measures is provided above.


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Liquidity and Capital Resources
Cash, cash equivalents and investment in marketable securities at SeptemberJune 30, 20192020, totaled $231.5$270.1 million. Working capital totaled $216.2$228.0 million at SeptemberJune 30, 2019,2020, as compared to $100.8$223.7 million at December 31, 2018,2019, an increase of $115.4$4.3 million, or 114.5%1.9%.
We have historically financed our operations primarily through internally generated funds. We generate cash primarily from capitations,capitation contracts, risk pool settlements and incentives, fees for medical management services provided to our affiliated physician groups, as well as fee-for-service reimbursements. We generally invest cash in money market accounts, which are classified as cash and cash equivalents. We believe we have sufficient liquidity to fund our operations at least through the next twelve12 months.
Our cash, cash equivalents and restricted cash increased by $123.5$49.2 million from $107.6$104.0 million at December 31, 20182019, to $231.1$153.2 million at SeptemberJune 30, 2019.2020. Cash providedgenerated by operating activities during the ninesix months ended SeptemberJune 30, 20192020, was $10.1 million.$12.6 million, as compared cash used of $22.0 million for the six months ended June 30, 2019. The cash provided by operations during the ninesix months ended SeptemberJune 30, 20192020, is a function of net income of $19.0$84.0 million, adjusted for the following non-cash operating items: depreciation and amortization of $13.8$9.3 million, impairment of intangible assets of $2.0 million, and share-based compensation of $1.0$1.9 million, which were offset by a change in deferred tax liability of $4.5 million, gain on sale of equity method investment of $99.3 million and earnings from equity method investments of approximately $1.1 million, release of provision for doubtful accounts of $1.4 million, gain related to assumption

of loan receivables of $2.3 million and a change in deferred tax liability of $0.2$2.9 million. Our cash provided by operating activities includesincluded a net decrease in operating assets and liabilities of $20.7$23.7 million.
Cash used ingenerated from investing activities during the ninesix months ended SeptemberJune 30, 20192020, was $60.4$67.2 million due primarily to the acquisitionsproceeds received related to the sale of several businesses, netUCI totaling $52.7 million and loan receivables of $16.5 million offset with cash totaling $49.4 million, a loan advanceoutflow related to the purchase of $7.4marketable securities of $1.1 million, funding for an equity method investment of $3.0$0.5 million, and capital expenditures (mainly purchases of property and equipment) of $0.8$0.4 million. This is compared to cash used of $50.2 million for the six months ended June 30, 2019 due to payments for business acquisition of $41.5 million, advances on loans receivable of $6.4 million, funding for an equity method investment of $2.2 million, and capital expenditures of $0.4 million offset with dividends received of $0.2 million$0.3 million.
Cash used in financing activities during the ninesix months ended SeptemberJune 30, 2019.
Cash2020, was $30.5 million as compared to cash provided by financing activities duringof $21.6 million for the ninesix months ended SeptemberJune 30, 20192019. Cash used for the six months ended June 30, 2020 was $173.7 million primarily due to net borrowingsthe payments of $237.0dividends totaling $30.2 million, repayment on our term loan totaling $2.4 million and repurchase of shares of $0.8 million, offset with proceeds from exercise of stock options and warrants of $3.1$2.9 million. This is compared to cash generated for the six months period ended June 30, 2019 due to proceeds from borrowings on our line of credit of $39.6 million, proceeds from the exercise of stock options and warrants of $0.9 million and proceeds from common stock offering of $0.2 million offset by dividendwith payments of $60.7dividends and repayments on our bank loan and lines of credit totaling $10.9 million and costs of debt and equity issuance costs of $5.7$8.0 million, during the nine months ended September 30, 2019.respectively.

Credit Facilities
The Company’s credit facility consisted of the following (in thousands):
June 30, 2020
Term loan A$185,250 
Revolver loan60,000 
Total debt245,250 
Less: Current portion of debt(9,500)
Less: Unamortized financing costs(5,295)
Long-term debt$230,455 
The following table presents scheduled commitments of the Company’s credit facility is to be as follows for the years ending December 31 (in thousands):
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Amount
2020 (excluding the six months ended June 30, 2020)$7,125  
202110,688  
202214,250  
202315,437  
2024197,750  
Total$245,250  
Credit FacilityAgreement
On        In September 11, 2019, the Company entered into a secured credit agreement (the “Credit Agreement”Agreement,” and the credit facility thereunder, the "Credit Facility") with Truist Bank (formerly known as SunTrust Bank,Bank), in its capacity as administrative agent for the lenders (in such capacity, the “Agent”), as a lender, an issuer of letters of credit and as swingline lender, and Preferred Bank, JPMorgan Chase Bank, N.A., MUFG Union Bank, N.A., Royal Bank of Canada, Fifth Third Bank and City National Bank, as lenders (the “Lenders”). In connection with the closing of the Credit Agreement, the Company, its subsidiary, NMM, and the Agent entered into a Guaranty and Security Agreement (the “Guaranty and Security Agreement”), pursuant to which, among other things, NMM guaranteed the obligations of the Company under the Credit Agreement.
The Credit Agreement provides for a five-year revolving credit facility to the Company of $100.0 million ("(“Revolver Loan"Loan”), which includes a letter of credit subfacility of up to $25.0 million. The Credit Agreement also provides for a term loan of $190.0 million, ("(“Term Loan A"A”). The unpaid principal amount of the term loan is payable in quarterly installments on the last day of each fiscal quarter commencing on December 31, 2019. The principal payment for each of the first eight fiscal quarters is $2.4 million, for the following eight fiscal quarters thereafter is $3.6 million and for the following three fiscal quarters thereafter is $4.8 million. The remaining principal payment on the term loan is due on September 11, 2024.
The proceeds of the term loan and up to $60.0 million of the revolving credit facility may bewere used to (i) finance a portion of the $545.0 million loan made by the Company to AP-AMH Medical Corporation, a California professional medical corporation (“AP-AMH”), concurrently with the closing of the Credit Agreement (the “AP-AMH Loan”) as described in the May 13, 2019 Current Report and the August 29, 2019 Current Report,Loan, (ii) refinance certain indebtedness of the Company and its subsidiaries and, indirectly, Allied Physicians of California, a Professional Medical Corporation, a California professional medical corporation (“APC”),APC, (iii) pay transaction costs and expenses arising in connection with the Credit Agreement, the AP-AMH Loan and certain other related transactions and (iv) provide for working capital, capital expenditures and other general corporate purposes. The remainder of the revolving credit facility will be used to finance future acquisitions and investments and to provide for working capital needs, capital expenditures and other general corporate purposes.
The Company is required to pay an annual facility fee of 0.20% to 0.35% on the available commitments under the Credit Agreement, regardless of usage, with the applicable fee determined on a quarterly basis based on the Company’s leverage ratio. The Company is also required to pay customary fees as specified in a separate fee agreement between the Company and SunTrust Robinson Humphrey, Inc., the lead arranger of the Credit Agreement.
Amounts borrowed under the Credit Agreement will bear interest at an annual rate equal to either, at the Company’s option, (a) the rate for Eurocurrency deposits for the corresponding deposits of U.S. dollars appearing on Reuters LIBOR01screen pageScreen LIBOR01 Page (“LIBOR”), adjusted for any reserve requirement in effect, plus a spread of frombetween 2.00% toand 3.00%, as determined on a quarterly basis based on the Company’s leverage ratio, or (b) a base rate, plus a spread ofbetween 1.00% toand 2.00%, as determined on a quarterly basis based on the Company’s leverage ratio. As of June 30, 2020, the interest rate on Term Loan A and Revolver Loan was 3.57% and 3.24%, respectively. The base rate is defined in a manner such that it will not be less than LIBOR. The Company will pay fees for standby letters of credit at an annual rate equal toof between 2.00% toand 3.00%, as determined on a quarterly basis based on the Company’s leverage ratio, plus facing fees and standard fees payable to the issuing bank on the respective letter of credit. Loans outstanding under the Credit Agreement may be prepaid at any time without penalty, except for LIBOR breakage costs and expenses. If LIBOR ceases to be reported, the Credit Agreement requires the Company and the Agent to endeavor to establish a commercially reasonable alternative rate of interest and until they are able to do so, all borrowings must be at the base rate.
The Credit Agreement requires the Company and its subsidiaries to comply with various affirmative covenants, including, without limitation, furnishing updated financial and other information, preserving existence and entitlements, maintaining

properties and insurance, complying with laws, maintaining books and records, requiring any new domestic subsidiary meeting a materiality threshold specified in the Credit Agreement to become a guarantor thereunder and paying obligations. The Credit Agreement requires the Company and its subsidiaries to comply with, and to use commercially reasonable efforts to the extent permitted by law to cause certain material associated practices of the Company, including APC, to comply with, restrictions on liens, indebtedness and investments (including restrictions on acquisitions by the Company), subject to specified exceptions.
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The Credit Agreement also contains various other negative covenants binding the Company and its subsidiaries, including, without limitation, restrictions on fundamental changes, dividends and distributions, sales and leasebacks, transactions with affiliates, burdensome agreements, use of proceeds, maintenance of business, amendments of organizational documents, accounting changes and prepayments and modifications of subordinated debt.
The Credit Agreement requires the Company to comply with two key financial ratios, each calculated on a consolidated basis. The Company must maintain a maximum consolidated leverage ratio of not greater than 3.75 to 1.00 as of the last day of each fiscal quarter. The maximum consolidated leverage ratio decreases by 0.25 each year, until it is reduced to 3.00 to 1.00 for each fiscal quarter ending after September 30, 2022. The Company must maintain a minimum consolidated interest coverage ratio of not less than 3.25 to 1.00 as of the last day of each fiscal quarter. As of SeptemberJune 30, 2019,2020, the Company was in compliance with the covenants relating to its credit facility.
Pursuant to the Guaranty and Security Agreement, the Company and NMM have granted the Lenders a security interest in all of their assets, including, without limitation, all stock and other equity issued by their subsidiaries (including NMM) and all rights with respect to the AP-AMH Loan. The Guaranty and Security Agreement requires the Company and NMM to comply with various affirmative and negative covenants, including, without limitation, covenants relating to maintaining perfected security interests, providing information and documentation to the Agent, complying with contractual obligations relating to the collateral, restricting the sale and issuance of securities by their respective subsidiaries and providing the Agent access to the collateral.
The Credit Agreement contains events of default, including, without limitation, failure to make a payment when due, default on various covenants in the Credit Agreement, breach of representations or warranties, cross-default on other material indebtedness, bankruptcy or insolvency, occurrence of certain judgments and certain events under the Employee Retirement Income Security Act of 1974 aggregating more than $10.0 million, invalidity of the loan documents, any lien under the Guaranty and Security Agreement ceasing to be valid and perfected, any change in control, as defined in the Credit Agreement, an event of default under the AP-AMH Loan, failure by APC to pay dividends in cash for any period of two consecutive fiscal quarters, failure by AP-AMH to pay cash interest to the Company, or if any modification is made to the Certificate of Determination or the Special Purpose Shareholder Agreement that directly or indirectly restricts, conditions, impairs, reduces or otherwise limits the payment of the Series A Preferred dividend by APC to AP-AMH. In addition, it will constitute an event of default under the Credit Agreement if APC uses all or any portion of the consideration received by APC from AP-AMH on account of AP-AMH’s purchase of Series A Preferred Stock for any purpose other than certain specific approved uses described in the following sentence, unless not less than 50.01% of all holders of common stock of APC at such time approve such use; provided that APC may use up to $50.0 million in the aggregate of such consideration for any purpose without any requirement to obtain such approval of the holders of common stock of APC. The approved uses include (i) any permitted investment, (ii) any dividend or distribution to the holders of the common stock of APC, (iii) any repurchase of common stock of APC, (iv) paying taxes relating to or arising from certain assets and transactions, or (v) funding losses, deficits or working capital support on account of certain non-healthcare assets in an amount not to exceed $125.0 million. If any event of default occurs and is continuing under the Credit Agreement, the Lenders may terminate their commitments, and may require the Company and its guarantors to repay outstanding debt and/or to provide a cash deposit as additional security for outstanding letters of credit. In addition, the Agent, on behalf of the Lenders, may pursue remedies under the Guaranty and Security Agreement, including, without limitation, transferring pledged securities of the Company’s subsidiaries in the name of the Agent and exercising all rights with respect thereto (including the right to vote and to receive dividends), collect on pledged accounts, instruments and other receivables (including the AP-AMH Loan), and all other rights provided by law or under the loan documents and the AP-AMH Loan.
In the ordinary course of business, certain of the Lenders under the Credit Agreement and their affiliates have provided to the Company and its subsidiaries and the associated practices, and may in the future provide, (i) investment banking, commercial banking (including pursuant to certain existing business loan and credit agreements being terminated in connection with entering into the Credit Agreement), cash management, foreign exchange or other financial services, and (ii) services as a bond trustee and other trust and fiduciary services, for which they have received compensation and may receive compensation in the future.


Deferred Financing Costs


TheIn September 2019, the Company recorded deferred financing costs of $6.4$6.5 million related to the issuance of the Credit Facility. This amount was recorded as a direct reduction of the carrying amount of the related debt liability. The deferred financing costs will be amortized over the life of the Credit Facility using the effective interest rate method.


Effective Interest Rate
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The Company’s average effective interest rate on its total debt during the six months ended June 30, 2020 and 2019, was 3.93% and 4.71%, respectively. Interest expense in the consolidated statements of income included amortization of deferred debt issuance costs for the three and ninesix months ended SeptemberJune 30, 2020 and 2019, was 1.02%of $0.3 million and 0.56%,$0, respectively, and $0.7 million and $0, respectively.
Lines of CreditRelated Party
NMM Business Loan
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$20.0 million with a maturity date of June 22, 2020. One of the Company’s board members is the Chairmanchairman 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$20.0 million to $27$27.0 million for the period from September 1, 2018 through January 31, 2019, further extended to October 31, 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”rate,” plus 0.125%, or 5.125% as of September 30, 2019 and 5.625% as of December 31, 2018. The loan was guaranteed by Apollo Medical Holdings, Inc. and is collateralized by substantially all of the assets of NMM. The amounts outstanding as of June 30, 2019, of $5.0 million was fully repaid on September 11, 2019.
On September 5, 2018, NMM entered into a non-revolving line of credit agreement with Preferred Bank, which provides for loan availability of up to $20.0 million with a maturity date of September 5, 2019. This credit facility was subsequently amended on April 17, 2019, and July 29, 2019, to reduce the loan availability from $20.0 million to $16.0 million and from $16.0 million to $2.2 million, respectively. The interest rate is based on the Wall Street Journal “prime rate”rate,” plus 0.125%, or 5.125%3.375% as of SeptemberJune 30, 20192020, and 5.625%4.875% as of December 31, 2018.2019. The line of credit is guaranteed by Apollo Medical Holdings, Inc. and is collateralized by substantially all assets of NMM. NMM obtained this line of credit to finance potential acquisitions. Each drawdown from the line of credit is converted into a five-year term loan with monthly principal payments, plus interest based on a five-year amortization schedule.
On September 11, 2019, the NMM Business Loan Agreement, dated as of June 14, 2018, between NMM and Preferred Bank, as amended, and the Line of Credit Agreement, dated as of September 5, 2018, between NMM and Preferred Bank, as amended, waswere terminated in connection with the closing of the Credit Facility.credit facility. Certain letters of credit issued by Preferred Bank under the Line of Credit Agreement waswere terminated and reissued under the Credit Agreement. TheseAs of June 30, 2020, outstanding letters of credit totaled $14.8 million as of September 30, 2019 and the companyCompany has $10.2 million available under the revolving credit facility.facility for letters of credit.
APC Business Loan
On June 14, 2018, APC amended its promissory note agreement with Preferred Bank, which provides for loan availability of up to $10.0 million with a maturity date of June 22, 2020. This credit facility was subsequently amended on April 17, 2019, and June 11, 2019, to increase the loan availability from $10.0 million to $40.0 million and extend the maturity date through December 31, 2020. On August 1, 2019, and September 10, 2019, this credit facility was further amended to increase loan availability from $40.0 million to $43.8 million, and decrease loan availability from $43.8 million to $4.1 million, respectively. This decrease further limited the purpose of the indebtedness under APC Business Loan Agreement to the issuance of standby letters of credit, and added as a permitted lien the security interest in all of its assets granted by APC in favor of NMM under a Security Agreement dated on or about September 11, 2019, securing APC’s obligations to NMM under, and as required pursuant to, that certain Management Services Agreementthe APC management services agreement dated as of July 1, 1999, as amended. The interest rate is based on the Wall Street Journal “prime rate”rate,” plus 0.125%, or 5.125%3.375% and 5.625%4.875% as of SeptemberJune 30, 20192020, and December 31, 2018,2019, respectively.
During the nine month period ended SeptemberAs of June 30, 2019, the Company drew down $39.6 million for capital to acquire Alpha Care. On September 11, 2019 in connection with the closing of the APC transaction the outstanding amount was fully repaid.
In connection with the closing of the Credit Agreement, there were no amounts outstanding as of September 30, 20192020 and December 31, 2018. As of September 30, 2019, and December 31, 2018,there was no availability under this line of credit was $0.0 million and $9.7 million, respectively.
Bank Loan
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 is 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.

credit.
Intercompany Loans
Each of AMH, MMG, BAHA, ACC,Apollo Care Connect, AKM Medical Group, Inc. ("AKM") and SCHC has entered into an Intercompany Loan Agreement with AMM under which AMM has agreed to provide a revolving loan commitment to each such affiliated entities in an amount set forth in each Intercompany Loan Agreement. Each Intercompany Loan Agreement provides that AMM’s obligation to make any advances automatically terminates concurrently with the termination of the management agreement with the applicable affiliated entity. In addition, each Intercompany Loan Agreement provides that (i) any material breach by the shareholder of record of the applicable Physician Shareholder Agreement or (ii) the termination of
59

the management agreement with the applicable affiliated entity constitutes an event of default under the Intercompany Loan Agreement. All the intercompany loans have been eliminated in consolidation. The following is a summary of the intercompany loans during the nine-month period ended September 30, 2019:consolidation (in thousands).
Six Months Ended June 30, 2020
EntityFacilityInterest
Rate
per Annum
Maximum
Balance
During
Period
Ending
Balance
Principal Paid
During Period
Interest
Paid
During
Period
AMH$10,000  10 %$6,193  $6,193  $—  $—  
Apollo Care Connect1,000  10 %1,283  1,283  —  —  
MMG3,000  10 %3,571  3,571  —  —  
AKM5,000  10 %—  —  —  —  
SCHC5,000  10 %4,940  4,940  —  —  
BAHA250  10 %4,066  4,066  —  —  
$24,250  $20,053  $20,053  $—  $—  
      Nine Months Ended September 30, 2019
Entity Facility 
Interest
rate
per Annum
 
Maximum
Balance
During
Period
 
Ending
Balance
 
Principal Paid
During Period
 
Interest
Paid
During
Period
AMH $10,000,000
 10% $5,601,308
 $5,601,308
 $770,000
 $
ACC 1,000,000
 10% 1,288,643
 1,283,078
 5,565
 
MMG 3,000,000
 10% 3,310,270
 3,310,270
 
 
AKM 5,000,000
 10% 
 
 
 
SCHC 5,000,000
 10% 4,508,707
 4,507,214
 
 
BAHA 250,000
 10% 4,065,992
 4,065,992
 
 
  $24,250,000
   $18,774,920
 $18,767,862
 $775,565
 $

Critical Accounting Policies and Estimates
The preparation of financial statements and related disclosures in conformity with accounting principles generally accepted in the United States of America (“U.S. GAAP”)GAAP requires our management to make judgments, assumptions and estimates that affect the amounts of revenue, expenses, income, assets and liabilities, reported in our condensed consolidated financial statements and accompanying notes. Actual results and the timing of recognition of such amounts could differ from those judgments, assumptions and estimates. In addition, judgments, assumptions and estimates routinely require adjustment based on changing circumstances and the receipt of new or better information. Understanding our accounting policies and the extent to which our management uses judgment, assumptions and estimates in applying these policies, therefore, is integral to understanding our financial statements. Critical accounting policies and estimates are defined as those that are reflective of significant judgments and uncertainties, and potentially result in materially different results under different assumptions and conditions. We summarize our most significant accounting policies in relation to the accompanying condensed consolidated financial statements in Note 2 thereto. Please also refer to the Critical Accounting Policies section of Management’s Discussion and Analysis of Financial Condition and Results of Operations included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2018.2019.

New Accounting Pronouncements
See Note 2 to the accompanying condensed consolidated financial statements for recently issued accounting pronouncements, including information on new accounting standards and the future adoption of such standards.

Off Balance

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Off-Balance Sheet Arrangements
As of SeptemberJune 30, 2019,2020, we had no off-balance sheet arrangements.arrangements that have or are reasonably likely to have a current or future effect on our financial condition, changes in financial condition, revenues or expenses, results of operations, liquidity, capital expenditures or capital resources that are material to investors.

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Inflation
Inflation and changing prices have had node minimis effect on our continuing operations over our two most recent fiscal years.

ITEM 3.  QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
Not applicable.

Interest Rate Risk

Borrowings under our Credit Agreement exposed us to interest rate risk. As of June 30, 2020, we had $245.3 million in outstanding borrowings under our Credit Agreement. The amount borrowed under the Credit Agreement bears interest at an annual rate equal to either, at the Company’s option, (a) the rate for Eurocurrency deposits for the corresponding deposits of U.S. dollars appearing on LIBOR, adjusted for any reserve requirement in effect, plus a spread of 2.00% to 3.00%, as determined on a quarterly basis based on the Company’s leverage ratio, or (b) a base rate, plus a spread of 1.00% to 2.00%, as determined on a quarterly basis based on the Company’s leverage ratio. The base rate is defined in a manner such that it will not be less than LIBOR. The Company will pay fees for standby letters of credit at an annual rate equal to 2.00% to 3.00%, as determined on a quarterly basis based on the Company’s leverage ratio, plus facing fees and standard fees payable to the issuing bank on the respective letter of credit. A hypothetical 1% change in our interest rates would have increased or decreased our interest expense for the three months ended June 30, 2020, by $2.5 million.

ITEM 4.  CONTROLS AND PROCEDURES
We conducted
Evaluation of Disclosure Controls and Procedures

As of June 30, 2020, we carried out an evaluation, under the supervision and with the participation of our management, including our chief executive officerCo-Chief Executive Officers and chief financial officer,Chief Financial Officer, of the effectiveness of the design and operation of our disclosure controls and procedures. Based on that evaluation, our management, including Co-Chief Executive Officers and Chief Financial Officer, concluded that our disclosure controls and procedures (asas defined in Rules 13a-15(e) and 15d-15(e)15(d)-15(e) under the Securities Exchange Act, of 1934, as amended)were effective as of the end of the period covered by this quarterly report. Based on this evaluation, our chief executive officer and chief financial officer concluded that, as of the evaluation date, our disclosure controls and procedures were not effective at the reasonable assurance level.
Our disclosure controls and procedures are designedJune 30, 2020, to ensure that the information relating to our company, including our consolidated subsidiaries, required to be disclosed by us in our SEC reportsthis Quarterly Report on Form 10-Q or submitted under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in SECthe Securities and Exchange Commission rules and forms and is(ii) accumulated and communicated to our management, including our chiefprincipal executive officerofficers and chiefprincipal financial officer, as appropriate, to allow for timely decisions regarding required disclosure.
Our management, including our chief executive officer and chief financial officer, does not expect that our disclosure controls or our internal control over financial reporting will prevent or detect all errors and all fraud. A control system, no matter how well designed and operated, can provide only reasonable, not absolute, assurance that the control system’s objectives will be met. The design of any system of controls is based in part on certain assumptions about the likelihood of future events, and there can be no assurance that any design will succeed in achieving its stated goals under all potential future conditions, and must reflect the facts that there are resource constraints and that the benefits of controls have to be considered relative to their costs. The inherent limitations in internal control over financial reporting include the realities that judgments can be faulty and that breakdowns can occur because of simple error or mistake. Controls also can be circumvented by the individual acts of some persons, by collusion of two or more people, or by management override of controls. In addition, over time, controls may become inadequate because of changes in circumstances, or the degree of compliance with the policies and procedures may deteriorate.
Based on management’s assessment of our internal control over financial reporting as of September 30, 2019, the following material weakness existed as of that date:
The Company did not maintain effective internal controls over the review of completeness and accuracy of data included in the full risk pool reports provided by an external party based on which material amounts of revenue were recognized. These reports are used to record an adjustment to accrue for additional surplus amounts, which represents a significant estimate of the expected variable consideration to be received upon settlement, primarily as it relates to revenue adjustments. As a result, unless remediated, there is a reasonable possibility that the Company's controls will fail to prevent or detect a misstatement related to full risk pools; and inaccuracies in the full risk pool reports could result in a potential material misstatement if not detected.
Notwithstanding the material weakness discussed above, our management, including our chief executive officer and chief financial officer, concluded that the condensed consolidated financial statements in this Report on Form 10-Q fairly present, in all material respects, the Company's financial condition, results of operations and cash flows for the periods presented, in conformity with U.S. GAAP.
Remediation Plan for Material Weakness in Internal Control over Financial Reporting
We are currently in the process of implementing our remediation plans. To date, we have implemented and are continuing to implement a number of measures to address the material weakness identified. Our management has taken the following actions that materially affect, or are reasonably likely to materially affect, our internal control over financial reporting: The Company continues to design new procedures to test the reliability of the information included in future full risk pool reports prepared for the Company by an external party and expects to implement these procedures during 2019 to remediate this control gap.disclosures.
Changes in Internal Control Over Financial Reporting
Beginning January 1, 2019, we implemented ASC 842, Leases. Although the new leasing standard did not have a material impact on our results of operations or cash flows, it did have a material impact on our financial position due to the recording of an operating lease right-of-use asset and operating lease liability beginning January 1, 2019. As a result, we implemented changes to our processes related to leases and the control activities within them during the three months ended March 31, 2019. These included ongoing contract review requirements and gathering of information provided for disclosures, as well as other requirements of the new lease guidance.
There were no other changes in our internal control over financial reporting (as defined in Rule 13a-15(f) under the Securities Exchange Act during our second fiscal quarter of 1934, as amended) during the period covered by this quarterly report2020 that have materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.


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PART II – OTHER INFORMATION
ITEM 1.  LEGAL PROCEEDINGS
In the ordinary course of our business, we from time to time become involved in pending and threatened legal actions and proceedings, most of which involve claims of medical malpractice related to medical services that are provided by our affiliated hospitalists. 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, which may not come to light until a substantial period of time has passed following contract implementation. We may also become subject to other lawsuits which could involve significant claims and/or significant defense costs, but as of the date of this Quarterly Report on Form 10-Q, except as disclosed, we are not a party to any lawsuit or proceeding, which in the opinion of management is expected to individually or in the aggregate have a material adverse effect on us or our business. Nonetheless, theThe 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.

ITEM 1A. RISK FACTORS
Our business, financial condition and operating results are affected by a number of factors, whether currently known or unknown, including risks specific to us or the healthcare industry, as well as risks that affect businesses in general. In addition to the information and risk factors set forth in this Quarterly Report on Form 10-Q, you should carefully consider the factors discussed in Part I, Item 1A, “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 20182019, filed with the SEC on March 18, 2019.16, 2020. The risks disclosed in such Annual Report and in this Quarterly Report could materially adversely affect our business, financial condition, cash flows or results of operations and thus our stock price. We believe there have been no material changes in our risk factors from those disclosed in the Annual Report except as described below. However, additional risks and uncertainties not currently known or we currently deem to be immaterial may also materially adversely affect our business, financial condition or results of operations.
These risk factors may be important to understanding other statements in this Quarterly Report and should be read in conjunction with the condensed consolidated financial statements and related notes in Part I, Item 1, “Financial Statements” and Part I, Item 2, “Management’s Discussion and Analysis of Financial Condition and Results of Operations” of this Quarterly Report.Report on Form 10-Q. Because of such risk factors, as well as other factors affecting the Company’s financial condition and operating results, past financial performance should not be considered to be a reliable indicator of future performance, and investors should not use historical trends to anticipate results or trends in future periods.
Risks RelatedThe current outbreak of the novel coronavirus disease, or COVID-19, or the future outbreak of any other highly infectious or contagious diseases, could adversely impact or cause disruption to our business, financial condition and results of operations.

An epidemic outbreak or other public health crisis nationally or in the markets where we operate could adversely affect our operations and financial results.  For example, the recent outbreak of COVID-19, the World Health Organization declared a pandemic on March 11, 2020, and which the U.S. declared a national emergency on March 13, 2020, has caused governments and the private sector globally to take a number of drastic precautionary measures to contain the spread of the coronavirus, including the restriction and suspension of in-person classes at schools, colleges and universities, the cancellation of public events and other nonessential mass gatherings and the implementation of work from home, stay at home and other quarantine directives.  The potential impact and duration of the COVID-19 pandemic has had, and continues to have, a significant adverse impact across regional and global economies and financial markets. The global impact of the outbreak has been rapidly evolving and as new cases of the virus have continued, particularly in the U.S., countries around the world and states around the U.S., have reacted by instituting quarantines and restrictions on travel.

Almost every state implemented shelter-in-place or stay-at-home directives between March and May 2020, including, among others, Los Angeles and San Bernardino counties, and the state of California, where we operate. The lockdown restrictions implemented included quarantines, restrictions on travel, shelter-in-place orders, school closures, restrictions on types of business that may continue to operate, and/or restrictions on types of construction projects that could continue. These quarantines generally came with exceptions for essential healthcare and public health operations, among other essential businesses.Beginning in early May 2020, the U.S. began to lift the lockdown restrictions and allow for the reopening of businesses. The gradual reopening of retail, manufacturing, and office facilities came with required or recommended safety protocols. There is no assurance that the reopening of businesses, even if those businesses adhere to recommended safety protocols, will enable us or our subsidiaries, VIEs, affiliated IPAs, contracted physician groups, service providers and suppliers to avoid adverse effects on our or their operations and businesses. Due to the Proposed APC Transaction.increase in the number of COVID-19 cases after the reopening of many states beginning in early June 2020, there is no assurance that local and state governments will not reinstitute new lockdown directives.
On September 11, 2019, ApolloMed, AP-AMH,
63

In order to protect our employees, we have implemented a number of precautionary measures, including a work from home policy, under which the vast majority of our employees currently operate. Such measures may have a substantial impact on employee attendance or productivity, or adversely affect our ability to recruit, attract or retain skilled personnel, which in turn may adversely affect our operations, including our ability to effectively provide management services to our affiliated IPAs and APC, concurrently consummated a seriescontracted physician groups in compliance with regulatory requirements.  An extended outbreak may also result in disruptions to critical infrastructures and our supply chains and the supply chains of interrelated transactions (collectively,our affiliated IPAs and contracted physician groups, including the “APC Transactions”). As disclosed elsewhere insupply of pharmaceuticals and medical supplies.  The duration and extent of the impact from the coronavirus outbreak depends on future developments that cannot be accurately predicted at this time, such as the severity and transmission rate of the virus, the extent and effectiveness of containment actions. If we are not able to respond to and manage the impact of such events effectively, our business could be harmed.

Although the Company’s operations have not been directly affected as of the date of this Quarterly Report on Form 10-Q, the Company is also monitoring potential impacts from weeks of widespread protests and in ApolloMed’s other reports on file withcivil unrest that began at the SEC, the APC Transactions included the following agreements and transactions: (i) ApolloMed made a $545.0 million ten-year secured loanend of May 2020 related to AP-AMH Loan; (ii) AP-AMH used all of the proceeds of that loanefforts to purchase 1,000,000 shares of Series A Preferred Stock of APC; (iii) ApolloMed obtained the funds to make the AP-AMH Loan (x) by entering into a $290.0 million senior secured credit facility (the "Credit Facility") with SunTrust Bank, in its capacity as administrative agent for various lenders, and then immediately drawing down $250.0 million in cash, and (y) by selling $300.0 million shares of ApolloMed common stock to APC, the purchase price of which was offset against $300.0 million of AP-AMH’s purchase price for its APC Preferred Stock. NMM guaranteed the obligations of ApolloMed under the Credit Facility, and both ApolloMed and NMM have granted the lenders a security interest in all of their assets, including, without limitation, in all stockinstitute law enforcement and other equity issued by their subsidiaries (including the sharessocial and political reforms.

64

The APC Transactions may expose ApolloMed, its subsidiaries and its VIEs to additional risks, including without limitation, the following: AP-AMH may never be able to repay the AP-AMH Loan; even if AP-AMH does not, or cannot repay the loan, ApolloMed will be obligated to pay principal and interest on the $290.0 million Credit Facility; in connection with the Credit Facility, the lenders were granted a first priority perfected security interest over all of the assets of ApolloMed and its subsidiaries, and such lenders have the right to foreclose on those assets if ApolloMed defaults on its obligations under the Credit Facility; a disconnect could arise between APC achieving net income, declaring and paying dividends to AP-AMH, and AP-AMH making its required payments to ApolloMed, which disconnect could materially impact ApolloMed's financial results and its ability to make its required payments under the Credit Facility; APC may be prohibited from paying, or may be unable to pay the dividends on its Series A Preferred Stock, including under the California Corporations Code; regulators could determine that the current, post-APC Transactions consolidated structure amounts to ApolloMed violating California’s corporate practice of medicine doctrine; and ApolloMed may be deemed an investment company, which could impose burdensome compliance requirements on ApolloMed and restrict its future activities.

The “Risk Factors” section of the definitive proxy statement of ApolloMed’s board of directors that ApolloMed filed with the SEC on July 31, 2019 (the “Proxy Statement”) described these and certain other risks related to the APC Transactions that could arise if the APC Transactions are consummated. Since the APC Transactions have now closed, the APC Transactions-related risk factors described in the “Risk Factors” portion of the Proxy Statement, including the risks described in the Proxy Statement under the headings listed below, are hereby incorporated herein by reference:

AP-AMH may never be able to repay the AP-AMH Loan.

Whether or not AP-AMH pays us, we will be obligated to pay principal and interest on the secured senior credit facility we are entering into in order to make the AP-AMH Loan.

The terms of the credit agreement we will need to secure could restrict our operations, particularly our ability to respond to changes in our business or to take specified actions, and an event of default under such credit agreement could harm our business.

In connection with the credit facility, the creditor will have a first priority perfected security interest over all of our assets and those of our subsidiaries, and such creditor would be able to foreclose on our assets if we default on our obligations under the credit facility and security agreement.

AP-AMH will be required to fund APC losses and deficits but may not have the funds to do so.

There may be a timing disconnect between APC achieving net income subject to the Series A Dividend, declaring and paying dividends to AP-AMH and AP-AMH’s payments to ApolloMed, and any failure to pay or late payment of dividends could materially impact our financial results.

The impact of the APC Transactions may prove to be negative in future periods.

If there is a change in accounting principles or the interpretation thereof affecting our anticipated accounting treatment for the APC Transactions, it could impact our earnings per share.

The Series A Dividends payable to AP-AMH must be declared by the APC board, and that board could fail to do so.

APC may be prohibited from paying or unable to pay the Series A Dividends, including under the California Corporations Code, which could cause the APC Transactions structure to collapse.

We may have no recourse against AP-AMH if it is unable to make its payments to ApolloMed and NMM.

The entitlement to receive the Series A Dividend will not necessarily mean that AP-AMH will be distributing all of the net income from APC’s Healthcare Services business and assets.

Regulators could determine that the post-APC Transactions consolidated structure amounts to ApolloMed violating California’s corporate practice of medicine doctrine.

ApolloMed could be subject to the California Finance Lenders Law as a result of the AP-AMH Loan.

We may be deemed an investment company, which could impose on us burdensome compliance requirements and restrict our activities.
ITEM 2.  UNREGISTERED SALES OF EQUITY SECURITIES AND USE OF PROCEEDS
During the three months ended SeptemberJune 30, 2019,2020, the Company issued an aggregate of 89,661214,033 shares of common stock and received approximately $814,506$1,976,152 from the exercise of certain warrants at an exercise price ofprices ranging between $9.00 -and $10.00 per share. The foregoing issuances were exempt from the registration provisions of the Securities Act of 1933, as amended, pursuant to Section 4(a)(2) thereof, and/or Regulation D promulgated thereunder.

ITEM 3.  DEFAULTS UPON SENIOR SECURITIES
None


ITEM 4. MINE SAFETY DISCLOSURES
Not applicable.

ITEM 5.  OTHER INFORMATION

None.

65

ITEM 6.  EXHIBITS
The following exhibits are either incorporated by reference into or filed or furnished with this Quarterly Report on Form 10-Q, as indicated below.
Exhibit
No.
Description
2.4
Stock purchase agreement dated March 15, 2019.2019(incorporated herein by reference to Exhibit 2.4 to the Company’s Quarterly Report on Form 10-Q filed on May 10, 2019)

10.1
10.2
10.3
10.4
10.5
10.6
31.1*
66

101.INS*XBRL Instance Document
101.SCH*XBRL Taxonomy Extension Schema Document
101.CAL*XBRL Taxonomy Extension Calculation Linkbase Document
101.DEF*XBRL Taxonomy Extension Definition Linkbase
101.LAB*XBRL Taxonomy Extension Label Linkbase Document
101.PRE*XBRL Taxonomy Extension Presentation Linkbase Document
††Management contract or compensatory plan or arrangement.
*Filed herewith.

**Furnished herewith
The schedules and exhibits thereof have been omitted pursuant to Item 601(b)(2) of Regulation S-K. A copy of any omitted schedule or exhibit will be furnished to the SEC upon request.

67

SIGNATURE
Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.
APOLLO MEDICAL HOLDINGS, INC.
APOLLO MEDICAL HOLDINGS, INC.
Dated: November 8, 2019August 7, 2020By:/s/ Kenneth Sim
Kenneth Sim, M.D.

Executive Chairman & Co-Chief Executive Officer

(Principal Executive Officer)

Dated: November 8, 2019August 7, 2020By:/s/ Thomas Lam
Thomas Lam, M.D., M.P.H.

Co-Chief Executive Officer & President

(Principal Executive Officer)
Dated: November 8, 2019August 7, 2020By:/s/ Eric Chin
Eric Chin

Chief Financial Officer
and Interim Co-Chief Operating Officer
(Principal Financial Officer)

7168