EX-99.2 3 tm269272d1_ex99-2.htm EXHIBIT 99.2

 

Exhibit 99.2

 

ASTRANA HEALTH, INC.

UNAUDITED PRO FORMA CONDENSED COMBINED STATEMENT OF INCOME

 

On July 1, 2025 (the “Closing”), Astrana Health, Inc. and its affiliates (the “Company” or “Astrana”), acquired substantially all the assets of certain direct and indirect subsidiaries of PHP Holdings, LLC (“PHPH”), including medical groups in multiple states (“Prospect Medical Group”) and a management services organization (“Prospect Medical Systems”), and all of the outstanding equity interests of Prospect Health Plan, Inc. (“PHP”), and Alta Newport Hospital, LLC (d/b/a Foothill Regional Medical Center) (“Alta”), pursuant to the Asset and Equity Purchase Agreement (the “Purchase Agreement”) dated November 8, 2024 (such transaction, the “Acquisition”).

 

The aggregate purchase price for the Acquisition consisted of approximately $674.9 million in cash transferred at Closing. To finance the Acquisition, the Company borrowed $707.3 million from a five-year delayed draw term loan credit facility (the “DDTL A”) pursuant to the Second Amended and Restated Credit Agreement, dated as of February 26, 2025, by and among the Company, as borrower, the lenders from time to time party thereto, and Truist Bank, as administrative agent for the lenders, as issuing bank and as swingline lender (the “Financing”, and together with the Acquisition, the “Transactions”).

 

The following unaudited pro forma condensed combined statement of income presents the financial information of Astrana, adjusted to give effect to the Transactions. The unaudited pro forma condensed combined statement of income has been prepared in accordance with Article 11 of Regulation S-X.

 

The following unaudited pro forma condensed combined statement of income combines the historical consolidated financial statements of Astrana and the historical combined and consolidated financial statements of PHP Holdings, LLC, Prospect Health Services RI, Inc., and Prospect Provider Group RI, LLC (which is substantially reflective of the assets and entities acquired in the Acquisition and are referred to hereinafter as the “Prospect Business”). Astrana’s fiscal year ends on December 31, and the fiscal year end of the Prospect Business was September 30. Although Astrana’s and the Prospect Business’s fiscal year ends differ by only one fiscal quarter, the Company has elected to prepare the unaudited pro forma condensed combined statement of income utilizing the historical statement of operations of the Prospect Business, adjusted to conform to the same calendar period as Astrana’s fiscal year. The unaudited pro forma condensed combined statement of income for the year ended December 31, 2025, combines Astrana’s historical results, which include the operations of the Prospect Business beginning July 1, 2025, with the Prospect Business’s historical results of operations for the six months ended June 30, 2025. These adjustments are presented on a pro forma basis to reflect the impact of the Transactions as if they had occurred on January 1, 2025. An unaudited pro forma condensed combined balance sheet is not presented as the Transactions have been fully reflected in the Company’s historical consolidated balance sheet as of December 31, 2025 included in Astrana’s annual report on Form 10-K, as filed with the SEC on March 12, 2026.

 

Assumptions and estimates underlying the unaudited pro forma adjustments included in the unaudited pro forma condensed combined statement of income are described in the accompanying notes. The unaudited pro forma adjustments are based on available preliminary information and certain assumptions that the Company believes are reasonable under the circumstances. The unaudited pro forma condensed combined statement of income for the year ended December 31, 2025, is presented for illustrative purposes only and is not necessarily indicative of the operating results that would have been achieved had the Transactions occurred on the date indicated above. The actual results of operations may differ significantly from the pro forma amounts reflected herein due to a variety of factors.

 

The following unaudited pro forma condensed combined statement of income gives effect to the following:

 

  · The Acquisition, inclusive of the following:

 

  · reclassification of certain historical financial information of the Prospect Business to conform to Astrana’s presentation of similar revenues and expenses;

 

  · the estimated adjustments associated with the preliminary allocation of the estimated purchase price to the acquired assets and assumed liabilities (i.e., depreciation and amortization expense);

 

  · the incremental interest expense effects associated with the Financing; and

 

  · the related income tax effects of the pro forma adjustments.

 

 

 

 

The Acquisition was accounted for under the acquisition method of accounting in accordance with Accounting Standards Codification (“ASC”) Topic 805, Business Combinations (“ASC 805”). Under the acquisition method of accounting, the total purchase price has been allocated to the tangible and intangible assets acquired and liabilities assumed of the Prospect Business based on their estimated fair values. The Company is currently finalizing its valuation of the acquired assets and liabilities. Preliminary amounts have been recorded and are subject to change, primarily for accounts that include the use of estimates, such as medical liabilities, collectability of receivables, accrued expenses, and tax liabilities. The pro forma adjustments arising from the preliminary allocation of the purchase price is based upon management’s estimates utilizing information currently available and is subject to revision as additional information on the fair value of the assets and liabilities become available and final appraisals and detailed analyses are completed.

 

The unaudited pro forma condensed combined statement of income was derived from, and should be read together with, the accompanying notes to the unaudited pro forma condensed combined statement of income, Astrana’s historical consolidated financial statements, accompanying notes, and Management’s Discussion and Analysis of Financial Condition and Results of Operations included in its annual report on Form 10-K for the fiscal year ended December 31, 2025, as filed with the Securities and Exchange Commission (the “SEC”) on March 12, 2026. The unaudited pro forma condensed combined statement of income should also be read together with the Prospect Business’s historical unaudited condensed combined and consolidated financial statements as of and for the nine months ended June 30, 2025, and related notes, filed as Exhibit 99.1 to this Current Report on Form 8-K. 

 

 

 

 

ASTRANA HEALTH, INC.

UNAUDITED PRO FORMA CONDENSED COMBINED STATEMENT OF INCOME

YEAR ENDED DECEMBER 31, 2025

(in thousands, except share and per share data)

 

   Historical       Pro Forma
       Prospect                      
       Business   Financing      Transaction           
   Astrana   As Adjusted   Adjustments      Adjustments      Pro Forma    
   As Reported   (Note 2)   (Note 3)   Note  (Note 3)   Note  Combined   Note
Revenue                             
Capitation, net  $2,924,265   $547,264   $-      $-      $3,471,529    
Risk pool settlements and incentives   86,199    12,142    -       -       98,341    
Management fee income   30,394    22,092    -       -       52,486    
Fee-for-service, net   112,635    45,820    -       -       158,455    
Other revenue   28,276    10,822    -       -       39,098    
                                   
Total revenue   3,181,769    638,140    -       -       3,819,909    
                                   
Operating expenses                                  
Cost of services, excluding depreciation and amortization   2,840,239    556,057    -       -       3,396,296    
General and administrative expenses   217,256    50,346    -       -   3(e)   267,602    
Depreciation and amortization   45,749    1,936    -       15,118   3(c)   62,803    
                                   
Total expenses   3,103,244    608,339    -       15,118       3,726,701    
                                   
Income from operations   78,525    29,801    -       (15,118)      93,208    
                                   
Other (expense) income                                  
(Loss) income from equity method investments   1,708    -    -       -       1,708    
Interest expense   (49,928)   (79,346)   (21,470)  3(a)   79,346   3(d)   (71,398)   
Interest income   12,157    938    -       -       13,095    
Unrealized gain (loss) on investments   (68)   -    -       -       (68)   
Other (loss) income   (2,788)   179    -       -       (2,609)   
                                   
Total other (expense) income, net   (38,919)   (78,229)   (21,470)      79,346       (59,272)   
                                   
Income (loss) before provision for income taxes   39,606    (48,428)   (21,470)      64,228       33,936    
                                   
Provision for income taxes   15,530    (36,931)   (6,205)  3(b)   18,562   3(f)   (9,044)   
                                   
Net income (loss)   24,076    (11,497)   (15,265)      45,666       42,980    
                                   
Net income attributable to noncontrolling interests   1,589    -    -       -       1,589    
                                   
Net income (loss) attributable to Astrana Health, Inc.  $22,487   $(11,497)  $(15,265)     $45,666      $41,391    
                                   
Earnings per share - basic  $0.46                        $0.84   Note 4
                                   
Earnings per share - diluted  $0.46                        $0.84   Note 4
                                   
Weighted average shares of common stock outstanding:                                  
Basic   49,075,727                         49,075,727   Note 4
Diluted   49,369,685                         49,369,685   Note 4

 

See Notes to Unaudited Pro Forma Condensed Combined Statement of Income

 

 

 

NOTES TO UNAUDITED PRO FORMA CONDENSED COMBINED STATEMENT OF INCOME

 

  1. Basis of Presentation

 

The unaudited pro forma condensed combined statement of income has been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) and Article 11 of Regulation S-X. The accompanying pro forma statement of income is based on the historical consolidated statement of income of Astrana for the year ended December 31, 2025, and the historical combined and consolidated statements of operations of the Prospect Business after giving effect to the Acquisition and the Financing, as well as certain reclassifications (see Note 2).

 

The Company accounted for the Acquisition under the acquisition method of accounting in accordance with ASC 805, with Astrana as the acquirer of the Prospect Business. In accordance with the acquisition method of accounting, Astrana recorded the preliminary estimated fair value of assets acquired and liabilities assumed from the Prospect Business on the acquisition date, July 1, 2025. Fair value is defined in ASC 820, Fair Value Measurements and Disclosures (“ASC 820”) as “the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date.” Fair value measurements can be highly subjective, and it is possible the application of reasonable judgment could result in different assumptions resulting in a range of alternative estimates using the same facts and circumstances. The Company is currently finalizing its valuation of the acquired assets and liabilities. Preliminary amounts have been recorded and are subject to change, primarily for accounts that include the use of estimates, such as medical liabilities, collectability of receivables, accrued expenses, and tax liabilities. The pro forma adjustments arising from the preliminary allocation of the purchase price is based upon management’s estimates utilizing information currently available and is subject to revision as additional information on the fair value of the assets and liabilities become available and final appraisals and detailed analyses are completed.

 

The unaudited pro forma condensed combined statement of income for the year ended December 31, 2025, combines Astrana’s historical results, which include the operations of the Prospect Business beginning July 1, 2025, with the Prospect Business’s historical results of operations for the six months ended June 30, 2025. These adjustments are presented on a pro forma basis to reflect the impact of the Transactions as if they had occurred on January 1, 2025.

 

The unaudited pro forma condensed combined statement of income for the fiscal year ended December 31, 2025, has been prepared using, and should be read in conjunction with, the following:

 

· Astrana’s audited consolidated statement of income for the fiscal year ended December 31, 2025, and the related notes included in Astrana’s annual report on Form 10-K for the fiscal year ended December 31, 2025, as filed with the SEC on March 12, 2026; and

 

· The Prospect Business’s unaudited condensed combined and consolidated financial statements as of and for the nine months ended June 30, 2025, and related notes, filed as Exhibit 99.1 to this Current Report on Form 8-K.

 

The foregoing historical financial statements have been prepared in accordance with GAAP. The unaudited pro forma condensed combined statement of income has been prepared based on the aforementioned historical financial statements and the assumptions and adjustments as described in the notes to the unaudited pro forma condensed combined statement of income. Management has made significant estimates and assumptions in its determination of the pro forma adjustments. As the unaudited pro forma condensed combined statement of income has been prepared based on these preliminary estimates, the final amounts recorded may differ materially from the information presented.

 

The unaudited pro forma condensed combined statement of income is not necessarily indicative of what the actual results of operations would have been had the Transactions taken place on the date indicated above, nor are they indicative of the future consolidated results of operations of the post-combination company. The unaudited pro forma condensed combined statement of income does not give effect to any synergies, operating efficiencies, tax savings or cost savings that may be associated with the Transactions.

 

See Note 3 of Astrana’s annual report on Form 10-K for the fiscal year ended December 31, 2025, for information regarding the purchase consideration, fair value estimates of the assets acquired and liabilities assumed, and resulting goodwill as of the acquisition date.

 

 

 

 

2. Accounting Policies and Reclassifications

 

The Company has performed a preliminary analysis to identify differences in Astrana’s and the Prospect Business’s historical financial statement presentation and significant accounting policies. As part of this analysis, Astrana has identified a required adjustment to the unaudited pro forma condensed combined statement of income to conform the Prospect Business’s significant accounting policies to Astrana’s, described in Note 2(i) below. Additionally, certain reclassification adjustments have been made to conform the Prospect Business’s historical statement of operations captions to Astrana’s statement of income captions in the unaudited pro forma condensed combined statement of income.

   

The following sets forth the reclassification and accounting policy adjustments made in the unaudited pro forma statement of income for the year ended December 31, 2025, to conform the Prospect Business’s presentation to Astrana’s presentation (in thousands):  

 

      For the Six Months Ended June 30, 2025 
      Prospect          Prospect 
      Business          Business 
Prospect Business caption  Astrana caption  (Note 5)   Reclassifications and Policy Adjustments   Note  As Adjusted 
Operating revenues:  Revenue                  
Capitation  Capitation, net  $547,264   $-      $547,264 
Patient services, net      53,636    (53,636)  2(a)   - 
   Fee-for-service, net        45,820   2(a)   45,820 
Management fees  Management fee income   22,092            22,092 
Other operating revenues      15,802    (15,802)  2(b)   - 
   Risk pool settlements and incentives        12,142   2(b)   12,142 
   Other revenue        3,006   2(b)   10,822 
            7,816   2(a)     
Total net revenue  Total revenue   638,794    (654)      638,140 
Cost of revenues:                     
Claims expense      326,088    (326,088)  2(c)   - 
Capitation expense      125,524    (125,524)  2(c)   - 
Other cost of revenues      28,082    (28,082)  2(c)   - 
Total cost of revenues      479,694    (479,694)      - 
Operating expenses:  Operating expenses:                  
   Cost of services, excluding depreciation and amortization   -    (475)  2(b)   556,057 
            479,694   2(c)     
            70,774   2(d)     
            881   2(e)     
            2,841   2(f)     
            1,377   2(g)     
            965   2(i)     
Salary and benefits      73,681    (73,681)  2(d)   - 
Outside services      20,501    (20,501)  2(e)   - 
Management fees      7,922    (7,922)  2(h)   - 
Professional fees      3,302    (3,302)  2(g)   - 
Marketing      1,414    (1,414)  2(h)   - 
Lease and rental expense      1,527    (1,527)  2(h)   - 
Repair, maintenance and utilities      3,239    (3,239)  2(h)   - 
Software licensing      5,027    (5,027)  2(h)   - 
Taxes, licenses and fees      3,582    (3,582)  2(f)   - 
Insurance      3,224    (3,224)  2(h)   - 
Other operating expenses      2,800    (2,800)  2(h)   - 
   General and administrative expenses   -    2,907   2(d)   50,346 
            19,620   2(e)     
            741   2(f)     
            1,925   2(g)     
            25,153   2(h)     
Depreciation and amortization  Depreciation and amortization   1,936            1,936 
Total operating expenses  Total expenses   128,155    480,184       608,339 
Operating income  Income from operations   30,945    (1,144)      29,801 
   Other (expense) income                  
Interest expense, net      (78,408)   78,408   2(j)   - 
   Interest expense        (79,346)  2(j)   (79,346)
   Interest income        938   2(j)   938 
   Other (loss) income        179   2(b)   179 
   Total other (expense) income, net   (78,408)   179       (78,229)
Loss before income taxes  (Loss) Income before provision for income taxes   (47,463)   (965)      (48,428)
Income tax (benefit) expense  Provision for income taxes   (36,931)           (36,931)
Net loss  Net (loss) income attributable to Astrana Health, Inc.  $(10,532)  $(965)     $(11,497)

 

 

 

 

2(a) Reflects the reclassification of “Patient services, net” on the Prospect Business’s statement of operations to “Fee-for-service, net” and “Other revenues” to conform to Astrana’s statement of income presentation.

 

2(b) Represents the reclassification of “Other operating revenues” on the Prospect Business’s statement of operations to “Risk pool settlements and incentives”, “Other revenues”, “Cost of services, excluding depreciation and amortization”, and “Other (loss) income” to conform to Astrana’s statement of income presentation.

 

2(c) Represents the reclassification of “Claims expense”, “Capitation expense”, and “Other costs of revenues” on the Prospect Business’s statement of operations to “Cost of services, excluding depreciation and amortization” to conform to Astrana’s statement of income presentation.

 

2(d) Represents the reclassification of “Salary and benefits” on the Prospect Business’s statement of operations to “Cost of services, excluding depreciation and amortization” and “General and administrative expenses” to conform to Astrana’s statement of income presentation.

 

2(e) Represents the reclassification of “Outside services” on the Prospect Business’s statement of operations to “Cost of services, excluding depreciation and amortization” and “General and administrative expenses” to conform to Astrana’s statement of income presentation.

 

2(f) Represents the reclassification of “Taxes, licenses and fees” on the Prospect Business’s statement of operations to “Cost of services, excluding depreciation and amortization” and “General and administrative expenses” to conform to Astrana’s statement of income presentation.

 

2(g) Represents the reclassification of “Professional fees” on the Prospect Business’s statement of operations to “Cost of services, excluding depreciation and amortization” and “General and administrative expenses” to conform to Astrana’s statement of income presentation.

 

2(h) Represents the reclassification of “Management fees”, “Marketing”, “Lease and rental expense”, “Repair, maintenance and utilities”, “Software licensing”, “Insurance” and “Other operating expenses” on the Prospect Business’s statement of operations to “General and administrative expenses” to conform to Astrana’s statement of income presentation.

 

2(i) Reflects an adjustment to reduce “Cost of services, excluding depreciation and amortization” to eliminate the change in the provision for adverse deviation reported by the Prospect Business to conform to Astrana’s policies, which do not include such a provision.

 

2(j) Represents the reclassification of “Interest expense, net” on the Prospect Business’s statement of operations to “Interest expense” and “Interest income” to conform to Astrana’s statement of income presentation.

 

 

 

 

3. Adjustments to Unaudited Pro Forma Condensed Combined Statement of Income

 

Pro Forma Financing Adjustments

 

The following pro forma adjustments are included in the unaudited pro forma condensed combined statement of income for the year ended December 31, 2025, to reflect the Financing as if it occurred on January 1, 2025:

 

3(a) Reflects the recognition of estimated incremental interest expense associated with the Financing, comprised of the following (in thousands):

 

   For the Year Ended 
   December 31, 2025 
Incremental interest expense on new $707.3 million DDTL A  $21,314 
Amortization of new deferred financing costs paid in connection with the Financing, net of amounts written off for reduction in delayed draw term loan commitment   156 
Total adjustment to interest expense  $21,470 

 

Actual interest expense arising from the Financing is included in Astrana’s historical results of operations beginning July 1, 2025. Therefore, the pro forma adjustment is calculated for the six months ended June 30, 2025.

 

The pro forma adjustment to interest expense is calculated based on an estimated interest rate of 6.08%, calculating using the three month Term SOFR as of July 1, 2025, plus a spread of 1.75%, representing the applicable spread as of July 1, 2025 based on the Company’s leverage ratio, in accordance with the terms of the Second Amended and Restated Credit Agreement. Interest expense on the DDTL A is variable and may be higher or lower depending on fluctuations in the benchmark rate of interest and the Company’s leverage ratio in each interest period.

 

The following table reflects the estimated impact to the pro forma adjustment to interest expense as a result of interest rate changes of plus or minus 12.5 basis points (in thousands):

 

   For the Year Ended 
Pro forma adjustment to interest expense:  December 31, 2025 
As presented  $21,470 
+ 12.5 basis points   21,908 
- 12.5 basis points   21,032 

 

For purposes of the unaudited pro forma condensed combined statement of income, the amortization of incremental deferred financing costs is calculated using the effective interest method for the six months ended June 30, 2025, assuming a five-year term beginning January 1, 2025.

 

3(b) Reflects an adjustment to the provision for income taxes as a result of the estimated income tax effects of the pro forma financing adjustments herein. The adjustment was calculated using a blended statutory income tax rate of 28.9%. The blended statutory tax rate is not necessarily indicative of the effective tax rate of Astrana in future periods, which could be significantly different depending on various factors.

 

 

 

 

Pro Forma Transaction Accounting Adjustments

 

The following pro forma adjustments are included in the unaudited pro forma condensed combined statement of income for the year ended December 31, 2025, to reflect the effects of the Acquisition as if it occurred on January 1, 2025:

 

3(c) Reflects the estimated incremental depreciation and amortization expense resulting from the Acquisition, and is comprised of the following (in thousands):

 

   For the Year Ended
December 31, 2025
 
     
Estimated incremental depreciation expense related to the acquired property and equipment  $1,080 
Estimated incremental amortization expense related to the acquired finite-lived intangibles   15,974 
Elimination of historical depreciation and amortization expense reported by the Prospect Business   (1,936)
Net adjustment to depreciation and amortization expense  $15,118 

 

Depreciation expense related to the acquired property and equipment and amortization expense related to the acquired finite-lived intangible assets are included in Astrana’s historical results of operations beginning July 1, 2025. Therefore, the pro forma adjustment for depreciation and amortization expense is calculated for the six months ended June 30, 2025.

 

The estimated incremental depreciation and amortization expenses are based on the preliminary fair values assigned to the acquired property and equipment and finite-lived intangibles. The finite-lived intangibles acquired in the Acquisition consist of member relationships, network relationships, management contracts, and a trade name. The Knox-Keene license acquired in the Acquisition was determined to be an indefinite-lived intangible asset and, accordingly, is not subject to amortization and does not impact the pro forma adjustment. For further discussion regarding the preliminary purchase price allocation, including the nature of the acquired finite-lived intangibles and the fair value measurements, refer to Note 3 of Astrana’s audited consolidated financial statements for the fiscal year ended December 31, 2025 included in Astrana’s annual report on Form 10-K, as filed with the SEC on March 12, 2026.

 

3(d) Reflects the reversal of the Prospect Business’ historical interest expense, inclusive of amortization of debt discounts and premiums for the six months ended June 30, 2025 that would not have been incurred had the Acquisition been consummated on January 1, 2025 as all outstanding debt obligations were settled at Closing and not assumed by Astrana pursuant to the terms of the Purchase Agreement.

 

3(e) Reflects no pro forma adjustments as all transaction costs are reflected in Astrana’s consolidated statement of income for the historical period. Astrana’s historical general and administrative expense includes approximately $19.6 million of non-recurring acquisition-related costs associated with the Acquisition.

 

3(f) Reflects an adjustment to the provision for income taxes as a result of the estimated income tax effects of the pro forma transaction accounting adjustments herein. The adjustment was calculated using a blended statutory income tax rate of 28.9%. The blended statutory tax rate is not necessarily indicative of the effective tax rate of Astrana in future periods, which could be significantly different depending on various factors.

 

 

 

 

4. Earnings per Share

 

Pro forma basic and diluted net earnings per share has been adjusted to reflect the pro forma adjustments herein for the year ended December 31, 2025. The following table sets forth the computation of pro forma combined basic and diluted net earnings per share (in thousands, except share and per share amounts):

 

   For the Year Ended
December 31, 2025
 
Pro forma net income attributable to Astrana Health, Inc.  $41,391 
      
Astrana historical weighted-average shares of common stock outstanding - basic(1)   49,075,727 
Pro forma weighted-average shares of common stock outstanding - basic   49,075,727 
      
Astrana historical weighted-average shares of common stock outstanding - diluted(1)   49,369,685 
Pro forma weighted-average shares of common stock outstanding - diluted   49,369,685 
      
Pro forma earnings per share attributable to Astrana Health, Inc. common stockholders:     
Basic  $0.84 
Diluted  $0.84 

 

(1) As reported by Astrana for the year ended December 31, 2025.

 

5. Prospect Business Statement of Operations Reconciliation

 

As previously discussed, Astrana’s fiscal year ends on December 31, and the fiscal year end of the Prospect Business is September 30. The Company has prepared the unaudited pro forma condensed combined statement of income utilizing the historical statements of operations of the Prospect Business, adjusted to conform to the same calendar period as Astrana’s fiscal year.

 

 

 

 

Astrana’s historical results include the operations of the Prospect Business beginning July 1, 2025. Therefore, the statement of operations data of the Prospect Business presented in the unaudited pro forma condensed combined statement of income for the year ended December 31, 2025, include the Prospect Business’s results of operations for the six months ended June 30, 2025, derived from the Prospect Business’s unaudited combined and consolidated statement of operations for the nine months ended June 30, 2025, and adjusted to exclude the three months ended December 31, 2024, as follows (in thousands):

 

   Nine Months
Ended
June 30, 2025
   Three Months
Ended
December 31, 2024
   Six Months
Ended
June 30, 2025
 
   (A)   (B)   (A - B) 
Operating revenues:               
Capitation  $830,370   $283,106   $547,264 
Patient services, net   81,797    28,161    53,636 
Management fees   29,061    6,969    22,092 
Other operating revenues   20,528    4,726    15,802 
Total net revenue   961,756    322,962    638,794 
                
Cost of revenues:               
Claims expense   488,946    162,858    326,088 
Capitation expense   189,794    64,270    125,524 
Other cost of revenues   44,112    16,030    28,082 
Total cost of revenues   722,852    243,158    479,694 
                
Gross margin   238,904    79,804    159,100 
                
Operating expenses:               
Salary and benefits   109,633    35,952    73,681 
Outside services   31,663    11,162    20,501 
Management fees   11,654    3,732    7,922 
Professional fees   4,846    1,544    3,302 
Marketing   2,122    708    1,414 
Lease and rental expense   2,316    789    1,527 
Repair, maintenance and utilities   4,635    1,396    3,239 
Software licensing   7,022    1,995    5,027 
Taxes, licenses and fees   5,365    1,783    3,582 
Insurance   4,110    886    3,224 
Depreciation and amortization   2,748    812    1,936 
Other operating expenses   4,314    1,514    2,800 
Total operating expenses   190,428    62,273    128,155 
                
Operating income   48,476    17,531    30,945 
                
Interest expense, net   (121,832)   (43,424)   (78,408)
                
Loss before income taxes   (73,356)   (25,893)   (47,463)
                
Income tax (benefit) expense   (34,666)   2,265    (36,931)
                
Net loss attributable to PHP Holdings, LLC & RI Market  $(38,690)  $(28,158)  $(10,532)