CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($)	9 Months Ended
	Sep. 30, 2019	Sep. 30, 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 amortization	13,792,581	14,819,627
Impairment of intangible	1,994,000	0
Loss on disposal of property and equipment	0	41,782
Provision for doubtful accounts	(1,363,415)	0
Share-based compensation	1,005,898	1,238,708
Gain on loan assumption	(2,250,000)	0
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, net	1,905,076	4,484,115
Receivable, net – related parties	5,864,052	(43,360,966)
Other receivables	(13,719,229)	0
Prepaid expenses and other current assets	(2,913,570)	(80,618)
Right-of-use assets	1,877,353	0
Other assets	(524,689)	(26,931)
Accounts payable and accrued expenses	4,868,437	31,701,367
Dividends payable	0	0
Incentives payable	0	(16,500,000)
Fiduciary accounts payable	195,544	0
Medical liabilities	(6,226,426)	(30,466,895)
Income taxes payable	(10,229,369)	(1,912,842)
Operating lease liabilities	(1,790,313)	0
Net cash provided by operating activities	10,084,821	31,864,880
Cash flows from investing activities
Payments for business acquisitions, net of cash acquired	(49,402,514)	0
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	0	(405,000)
Purchases of property and equipment	(806,590)	(867,732)
Dividend received	240,000	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	0	27,300
Payment of capital lease obligations	(76,020)	(73,775)
Proceeds from the exercise of stock options and warrants	2,400,330	3,574,046
Repurchase of shares	(40,000)	0
Borrowings on line of credit and long-term debt	289,600,000	8,000,000
Proceeds from common stock offering	754,998	200,000
Cost of debt and equity issuance costs	(5,621,831)	0
Net cash provided by (used in) financing activities	173,706,911	(5,373,713)
Net increase in cash, cash equivalents and restricted cash	123,427,533	6,242,992
Cash, cash equivalents and restricted cash, beginning of period	107,636,973	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 interest	999,582	287,332
Supplemental disclosures of non-cash investing and financing activities
Cashless exercise of stock options	0	47
Deferred tax liability adjustment to goodwill	11,539,600	1,110,456
APC stock issued in exchange for AMG	414,250	0
Reconciliation of cash, cash equivalents, and restricted cash
Cash and cash equivalents	230,298,252	119,779,499
Restricted cash – short-term - distributions to former NMM shareholders	20,150	4,218,176
Restricted cash – letters of credit	746,104	745,412
Total cash, cash equivalents, and restricted cash shown in the statement of cash flows	$ 107,636,973	$ 118,500,095