CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Cash flows from operating activities
Net income	$ 62,208,688	$ 24,913,613
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	14,819,627	14,407,113
Loss on disposal of property and equipment	41,782	0
Share-based compensation	1,238,708	963,699
Unrealized loss (gain) from investment in equity securities	10,218	(79,527)
Change in fair value of derivative instrument	0	278,886
Loss from equity method investments	2,573,219	28,936
Deferred tax	7,135,408	(5,730,758)
Changes in operating assets and liabilities, net of acquisition amounts:
Receivables, net	(38,366,867)	263,132
Prepaid expenses and other current assets	(590,602)	(736,525)
Other assets	(26,931)	(131,983)
Accounts payable and accrued expenses	31,701,367	(1,897,636)
Incentives payable	(16,500,000)	(7,939,317)
Medical liabilities	(30,466,895)	(752,876)
Income taxes payable	(1,912,842)	12,733,179
Net cash provided by operating activities	31,864,880	36,319,936
Cash flows from investing activities
Purchases of marketable securities	(9,013)	(5,283)
Repayments from related parties – loans receivable	0	200,000
Advances to related parties - loans receivable	(2,500,000)	(5,000,000)
Purchase of investments – joint venture	(16,673,840)	(400,000)
Dividends received from equity method investments	207,410	1,000,000
Purchase of investment in a privately held entity	(405,000)	0
Proceeds on sale of investments - cost method	0	25,000
Purchases of property and equipment	(867,732)	(1,627,760)
Net cash used in investing activities	(20,248,175)	(5,808,043)
Cash flows from financing activities
Repayment of bank loan	(375,485)	0
Dividends paid	(16,725,799)	(9,490,632)
Change in noncontrolling interest capital	27,300	0
Borrowings on line of credit	8,000,000	0
Payment of capital lease obligations	(73,775)	(78,343)
Proceeds from sale of common stock of VIE	200,000	0
Proceeds from the exercise of stock options and warrants	3,574,046	425,025
Net cash used in financing activities	(5,373,713)	(9,143,950)
Net increase in cash, cash equivalents and restricted cash	6,242,992	21,367,943
Cash, cash equivalents and restricted cash, beginning of period	118,500,095	54,925,712
Cash, cash equivalents and restricted cash, end of period	124,743,087	76,293,655
Supplementary disclosures of cash flow information:
Cash paid for income taxes	18,032,590	9,489,563
Cash paid for interest	287,332	1,748
Supplemental disclosures of non-cash investing and financing activities
Cashless exercise of stock options	47	0
Deferred tax liability adjustment to goodwill	1,110,456	0
Cumulative effect adjustment for ASC 606 included in accounts receivable	11,600,000	0
Cumulative effect adjustment for ASC 606 included in deferred tax liabilities	3,246,098	0
Purchase price adjustment for acceleration of vested stock options	868,000	0
Conversion of loan receivable to investment in Accountable Health Care, IPA	5,000,000	0
Reclassification of dividends payable to accounts payable and accrued expenses	432,113	0
Reclassification of APS noncontrolling interest to equity	443,184	0
Reclassification of stock options exercised to liability for unissued common shares	0	425,025
Reclassification of fiduciary cash to payable	1,416,972	51,525
Reconciliation of cash, cash equivalents, and restricted cash
Cash and cash equivalents	119,779,499	76,293,655
Restricted cash - long-term - letters of credit	745,412	0
Restricted cash - short-term - distributions to former NMM shareholders	4,218,176	0
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows	$ 124,743,087	$ 76,293,655