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      Astrana Health, Inc. Reports First Quarter 2025 Results

      Astrana Health Logo (PRNewsfoto/Astrana Health, Inc.)

      News provided by

      Astrana Health, Inc.

      May 08, 2025, 16:05 ET

      Share this article

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      Company to Host Conference Call on Thursday, May 8, 2025, at 2:30 p.m. PT/5:30 p.m. ET

      ALHAMBRA, Calif., May 8, 2025 /PRNewswire/ -- Astrana Health, Inc. ("Astrana," and together with its subsidiaries and affiliated entities, the "Company") (NASDAQ: ASTH), a leading provider-centric, technology-powered healthcare company enabling providers to deliver accessible, high-quality, and high-value care to all, today announced its consolidated financial results for the first quarter ended March 31, 2025.

      "Astrana's strong start to the year reflects the continued momentum behind our mission to build the nation's leading patient-centered healthcare platform. Our differentiated clinical capabilities and technology-enabled delegated model continue to drive strong, profitable growth while delivering better outcomes for both patients and providers. Even in a complex regulatory and economic environment, we continue to prove that value-based care can deliver meaningful impact at scale with long-term sustainability," said Brandon Sim, President and CEO of Astrana Health. 

      Financial Highlights for three months ended March 31, 2025:

      All comparisons are to the three months ended March 31, 2024 unless otherwise stated.

      • Total revenue of $620.4 million, up 53% from $404.4 million
      • Care Partners revenue of $601.0 million, up 57% from $382.3 million
      • Net income attributable to Astrana of $6.7 million, compared to $14.8 million
      • Earnings per share - diluted ("EPS - diluted") of $0.14, compared to $0.31
      • Adjusted EBITDA(1) of $36.4 million, compared to $42.2 million

      (1) See "Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin" and "Use of Non-GAAP Financial Measures" below for additional information.

      Recent Operating Highlights

      • Astrana announced several additions to its leadership team to support continued growth and execution. The Company welcomes Georgie Sam, Chief Data & Analytics Officer, who will oversee enterprise-wide data and analytics strategy to deliver even faster, more actionable insights to our stakeholders, and Glenn Sobotka, Chief Accounting Officer, who brings deep experience to support Astrana's continued financial discipline and scalability. Rita Pew was promoted to the role of Chief People Officer, helping Astrana further invest in the talent and culture that drive Astrana forward.
      • Astrana successfully completed the integration of Collaborative Health Systems ("CHS") and onboarded the entity to the Company's proprietary technology platform, already resulting in material general and administrative ("G&A") efficiencies.
      • Astrana received Hart-Scott-Rodino ("HSR") approval for its pending acquisition of Prospect Health, which remains on track to close this summer.

      Segment Results for three months ended March 31, 2025:
      All comparisons are to the three months ended March 31, 2024 unless otherwise stated.



      Three Months Ended March 31, 2025


      (in thousands)


      Care
      Partners



      Care
      Delivery



      Care
      Enablement



      Intersegment
      Elimination



      Corporate
      Costs



      Consolidated
      Total


      Total revenues


      $

      600,951



      $

      33,388



      $

      39,562



      $

      (53,511)



      $

      —



      $

      620,390


      % change vs. prior year quarter



      57

      %



      9

      %



      19

      %





























      Cost of services



      512,668




      27,139




      25,818




      (16,564)




      —




      549,061


      General and administrative(1)



      44,068




      9,357




      10,209




      (36,950)




      24,062




      50,746


      Total expenses



      556,736




      36,496




      36,027




      (53,514)




      24,062




      599,807





















      Income (loss) from operations


      $

      44,215



      $

      (3,108)



      $

      3,535



      $

      3


      (2)

      $

      (24,062)



      $

      20,583


      % change vs. prior year quarter



      2

      %


      *




      1

      %











      * Percentage change of over 500%

      (1) Balance includes general and administrative expenses and depreciation and amortization.

      (2) Income from operations for the intersegment elimination represents sublease income between segments. Sublease income is presented within other income that is not presented in the table.

      2025 Guidance:

      Astrana is providing the following guidance for total revenue and Adjusted EBITDA for the quarter ended June 30, 2025 and reiterating guidance for the year ended December 31, 2025 based on the Company's existing business, current view of existing market conditions, and assumptions. The following guidance for the year ended December 31, 2025 includes approximately $15 million in expected costs associated with continued strategic investments in automation and AI, as well as ongoing and expected integration costs associated with planned acquisitions, but does not include contributions from any acquisitions which have not yet closed.

      ($ in millions)


      Three Months Ended
      June 30, 2025



      Year Ended
      December 31, 2025



      Guidance Range



      Guidance Range



      Low



      High



      Low



      High

      Total revenue


      $

      615



      $

      655



      $

      2,500



      $

      2,700

      Adjusted EBITDA


      $

      45



      $

      50



      $

      170



      $

      190

      See "Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA" and "Use of Non-GAAP Financial Measures" below for additional information. There can be no assurance that actual amounts will not be materially higher or lower than these expectations. See "Forward-Looking Statements" below for additional information.

      Conference Call and Webcast Information:

      Astrana will host a conference call at 2:30 p.m. PT/5:30 p.m. ET today (Thursday, May 8, 2025), during which management will discuss the results of the first quarter ended March 31, 2025. To participate in the conference call, please use the following dial-in numbers about 5 minutes prior to the scheduled conference call time:

      U.S. & Canada (Toll-Free):       +1 (877) 858-9810
      International (Toll):                   +1 (201) 689-8517

      The conference call can also be accessed via webcast at: https://event.choruscall.com/mediaframe/webcast.html?webcastid=HE6dr7eJ 

      An accompanying slide presentation will be available in PDF format on the "IR Calendar" page of the Company's website (https://ir.astranahealth.com/news-events/ir-calendar) after issuance of the earnings release and will be furnished as an exhibit to Astrana's current report on Form 8-K to be filed with the SEC, accessible at www.sec.gov. 

      Those who are unable to attend the live conference call may access the recording at the above webcast link, which will be made available shortly after the conclusion of the call.

      Note About Consolidated Entities

      The Company consolidates entities in which it has a controlling financial interest. The Company consolidates subsidiaries in which it holds, directly or indirectly, more than 50% of the voting rights, and variable interest entities ("VIEs") in which the Company is the primary beneficiary. Noncontrolling interests represent third party equity ownership interests in the Company's consolidated entities (including certain VIEs). The amount of net income attributable to noncontrolling interests is disclosed in the Company's consolidated statements of income.

      About Astrana Health, Inc.

      Astrana Health is a physician-centric, technology-enabled healthcare company committed to delivering access to high-quality, patient-centered care. Through its proprietary end-to-end technology platform, Astrana empowers providers to deliver more proactive, preventive care - improving patient outcomes, elevating patient experiences, improving the well-being of providers, and driving greater value.

      Today, Astrana supports more than 12,000 providers and over one million Americans in value-based arrangements through its affiliated provider networks, management services organization, and primary, specialty, and ancillary care delivery clinics. Together, Astrana is building what our healthcare system should be - one that delivers better care, better experiences, and better outcomes for all. For more information, visit www.astranahealth.com.

      Forward-Looking Statements

      This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995, such as statements about the Company's guidance for the quarter ending June 30, 2025 and the year ending December 31, 2025, ability to meet operational goals, ability to meet expectations in deployment of care coordination and management capabilities, ability to decrease cost of care while improving quality and outcomes, ability to deliver sustainable revenue and EBITDA growth as well as long-term value, ability to respond to the changing environment, statements about the Company's liquidity, and successful completion and implementation of strategic growth plans, acquisition strategy, and merger integration efforts. Forward-looking statements reflect current views with respect to future events and financial performance and therefore cannot be guaranteed. Such statements are based on the current expectations and certain assumptions of the Company's management, and some or all of such expectations and assumptions may not materialize or may vary significantly from actual results. Actual results may also vary materially from forward-looking statements due to risks, uncertainties and other factors, known and unknown, including the risk factors described from time to time in the Company's reports to the SEC, including, without limitation the risk factors discussed in the Company's Annual Report on Form 10-K for the year ended December 31, 2024, and any subsequent quarterly reports on Form 10-Q. Any forward-looking statement made by the Company in this release speaks only as of the date on which it is made. The Company undertakes no obligation to publicly update any forward-looking statement, whether as a result of new information, future developments or otherwise, except as may be required by any applicable securities laws.

      FOR MORE INFORMATION, PLEASE CONTACT:

      Investor Relations
      (626) 943-6491
      [email protected] 

      ASTRANA HEALTH, INC.

      CONDENSED CONSOLIDATED BALANCE SHEETS

      (IN THOUSANDS, EXCEPT SHARE AND PER SHARE DATA)




      March 31,
      2025



      December 31,
      2024




      (Unaudited)












      Assets














      Current assets









      Cash and cash equivalents


      $

      258,517



      $

      288,455


      Investment in marketable securities



      2,397




      2,378


      Receivables, net



      241,078




      225,733


      Receivables, net – related parties



      56,846




      50,257


      Income taxes receivable



      15,802




      19,316


      Other receivables



      14,919




      29,496


      Prepaid expenses and other current assets



      23,711




      22,861









      Total current assets



      613,270




      638,496









      Non-current assets







      Property and equipment, net



      16,849




      14,274


      Intangible assets, net



      111,916




      118,179


      Goodwill



      416,386




      419,253


      Income taxes receivable



      15,943




      15,943


      Loans receivable, non-current



      48,134




      51,266


      Investments in other entities – equity method



      38,005




      39,319


      Investments in privately held entities



      8,896




      8,896


      Restricted cash



      647




      646


      Operating lease right-of-use assets



      30,698




      32,601


      Other assets



      30,512




      16,021









      Total non-current assets



      717,986




      716,398









      Total assets(1)


      $

      1,331,256



      $

      1,354,894









      Liabilities, Mezzanine Deficit, and Stockholders' Equity














      Current liabilities







      Accounts payable and accrued expenses


      $

      105,559



      $

      106,142


      Fiduciary accounts payable



      4,840




      8,223


      Medical liabilities



      204,101




      209,039


      Dividend payable



      638




      638


      Finance lease liabilities



      471




      554


      Operating lease liabilities



      4,979




      5,350


      Current portion of long-term debt



      12,500




      9,375


      Other liabilities



      28,180




      26,287









      Total current liabilities



      361,268




      365,608









      Non-current liabilities







      Deferred tax liability



      4,197




      4,555


      Finance lease liabilities, net of current portion



      543




      607


      Operating lease liabilities, net of current portion



      28,963




      30,654


      Long-term debt, net of current portion and deferred financing costs



      403,894




      425,299


      Other long-term liabilities



      14,685




      14,003









      Total non-current liabilities



      452,282




      475,118









      Total liabilities(1)



      813,550




      840,726









      Mezzanine deficit







      Noncontrolling interest in Allied Physicians of California, a Professional Medical Corporation ("APC")



      (232,733)




      (202,558)









      Stockholders' equity







      Preferred stock, $0.001 par value per share; 5,000,000 shares authorized as of
      March 31, 2025 and December 31, 2024







      Series A Preferred stock, zero authorized and issued and zero outstanding as of
      March 31, 2025 and zero authorized and issued and zero outstanding as of
      December 31, 2024



      —




      —


      Series B Preferred stock, zero authorized and issued and zero outstanding as of
      March 31, 2025 and zero authorized and issued and zero outstanding as of
      December 31, 2024



      —




      —


      Common stock, $0.001 par value per share; 100,000,000 shares authorized,
      49,028,624(2) and 47,929,872 shares issued and outstanding, excluding 9,903,953
      and 10,603,849 treasury shares, as of March 31, 2025 and December 31, 2024,
      respectively



      49




      48


      Additional paid-in capital



      452,439




      426,389


      Retained earnings



      292,880




      286,283


      Total stockholders' equity



      745,368




      712,720









      Non-controlling interest



      5,071




      4,006









      Total equity



      750,439




      716,726









      Total liabilities, mezzanine deficit, and stockholders' equity


      $

      1,331,256



      $

      1,354,894



      (1) The Company's condensed consolidated balance sheets include the assets and liabilities of its consolidated VIEs. The condensed consolidated balance sheets include total assets that can be used only to settle obligations of the Company's consolidated VIEs totaling $678.1 million and $712.3 million as of March 31, 2025 and December 31, 2024, respectively, and total liabilities of the Company's consolidated VIEs for which creditors do not have recourse to the general credit of the primary beneficiary of $212.1 million and $207.9 million as of March 31, 2025 and December 31, 2024, respectively. These VIE balances do not include $190.2 million of investment in affiliates and $4.5 million of amounts due to affiliates as of March 31, 2025, and $224.9 million of investment in affiliates and $48.1 million of amounts due to affiliates as of December 31, 2024, as these are eliminated upon consolidation and not presented within the condensed consolidated balance sheets.

      (2) As of May 5, 2025, there were 56,061,712 shares of common stock of the registrant issued and outstanding, which includes 6,132,802 treasury shares that are owned by Allied Physicians of California, a Professional Medical Corporation d.b.a. Allied Pacific of California IPA ("APC"). The shares owned by APC are legally issued and outstanding but excluded from shares of common stock outstanding in the Company's consolidated financial statements. The shares are treated as treasury shares for accounting purposes and not included in the number of shares of common stock outstanding used to calculate the Company's earnings per share.

      Included in the Company's common stock as outstanding in the consolidated financial statements are 41,048 holdback shares that have not been issued to certain former shareholders of the Company's subsidiary, Astrana Health Management, Inc. ("AHM"). The former AHM shareholders, who were AHM shareholders at the time of closing of the merger, have yet to submit properly completed letters of transmittal to Astrana in order to receive their pro rata portion of Astrana's common stock as contemplated under that certain Agreement and Plan of Merger, dated December 21, 2016, among Astrana, AHM, Apollo Acquisition Corp. ("Merger Subsidiary") and Kenneth Sim, M.D., as amended, pursuant to which Merger Subsidiary merged with and into AHM, with AHM as the surviving corporation. Pending such receipt, such former AHM 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 Company's consolidated financial statements have treated such shares of common stock as outstanding, given the receipt of the letter of transmittal is considered perfunctory and Astrana is legally obligated to issue these shares in connection with the merger.

      ASTRANA HEALTH, INC.

      CONSOLIDATED STATEMENTS OF INCOME

      (IN THOUSANDS, EXCEPT PER SHARE AMOUNTS)

      (UNAUDITED)




      Three Months Ended
      March 31,




      2025



      2024


      Revenue







      Capitation, net


      $

      583,963



      $

      365,910


      Risk pool settlements and incentives



      14,491




      17,377


      Management fee income



      2,310




      4,078


      Fee-for-service, net



      14,890




      15,937


      Other revenue



      4,736




      1,054









      Total revenue



      620,390




      404,356









      Operating expenses







      Cost of services, excluding depreciation and amortization



      549,061




      330,399


      General and administrative expenses



      43,897




      38,722


      Depreciation and amortization



      6,849




      5,096









      Total expenses



      599,807




      374,217









      Income from operations



      20,583




      30,139









      Other expense







      (Loss) income from equity method investments



      (867)




      632


      Interest expense



      (7,308)




      (7,585)


      Interest income



      2,312




      3,996


      Unrealized (loss) gain on investments



      (44)




      1,099


      Other loss



      (5,072)




      (4,277)









      Total other expense, net



      (10,979)




      (6,135)









      Income before provision for income taxes



      9,604




      24,004









      Provision for income taxes



      3,383




      7,142









      Net income



      6,221




      16,862









      Net (loss) income attributable to non-controlling interest



      (471)




      2,027









      Net income attributable to Astrana Health, Inc.


      $

      6,692



      $

      14,835









      Earnings per share – basic


      $

      0.14



      $

      0.31









      Earnings per share – diluted


      $

      0.14



      $

      0.31


      ASTRANA HEALTH, INC.

      CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

      (IN THOUSANDS)

      (UNAUDITED)




      Three Months Ended
      March 31,




      2025



      2024









      Cash flows from operating activities







      Net income


      $

      6,221



      $

      16,862


      Adjustments to reconcile net income to net cash provided by operating activities:







      Depreciation and amortization



      6,849




      5,096


      Amortization of debt issuance cost



      691




      458


      Share-based compensation



      7,811




      5,748


      Non-cash lease expense



      1,287




      3,155


      Change in fair value of contingent consideration liabilities



      1,407




      —


      Loss on debt extinguishment



      375




      —


      Unrealized loss (gain) on investments



      44




      (1,099)


      Loss (income) from equity method investments



      867




      (632)


      Deferred tax



      (358)




      (7,248)


      Other



      (557)




      6,795


      Changes in operating assets and liabilities, net of business combinations:







      Receivables, net



      (10,368)




      (26,128)


      Receivables, net – related parties



      (6,589)




      (3,374)


      Other receivables



      3,688




      (1,403)


      Prepaid expenses and other current assets



      2,674




      (4,255)


      Other assets



      (314)




      92


      Accounts payable and accrued expenses



      8




      905


      Fiduciary accounts payable



      (3,383)




      56


      Medical liabilities



      3,319




      (808)


      Income taxes receivable



      3,514




      14,542


      Operating lease liabilities



      (1,090)




      (3,083)


      Other long-term liabilities



      531




      298


      Net cash provided by operating activities



      16,627




      5,977









      Cash flows from investing activities







      Payments for business acquisition, net of cash acquired



      —




      (50,649)


      Proceeds from repayment of promissory notes, including those with related parties



      600




      6


      Purchase of marketable securities



      (24)




      (27)


      Issuance of loan receivable



      —




      (20,000)


      Purchases of property and equipment



      (3,070)




      (369)


      Distribution from investment - equity method



      100




      —


      Net cash used in investing activities



      (2,394)




      (71,039)









      Cash flows from financing activities







      Dividends paid



      (5,455)




      (95)


      Borrowings on long-term debt



      412,000




      110,000


      Repayment of long-term debt



      (428,232)




      (3,500)


      Payment of finance lease obligations



      (147)




      (179)


      Deferred financing cost



      (17,241)




      —


      Proceeds from ESPP purchases



      301




      —


      Taxes paid from net share settlement of restricted stock



      (4,052)




      —


      Repurchase of treasury shares



      (1,316)




      —


      Proceeds from sale of non-controlling interest



      —




      150


      Purchase of non-controlling interest



      (28)




      (25)


      Net cash (used in) provided by financing activities



      (44,170)




      106,351









      Net (decrease) increase in cash, cash equivalents, and restricted cash



      (29,937)




      41,289









      Cash, cash equivalents, and restricted cash, beginning of period



      289,101




      294,152









      Cash, cash equivalents, and restricted cash, end of period


      $

      259,164



      $

      335,441









      Supplemental disclosures of cash flow information







      Cash paid for income taxes


      $

      4,338



      $

      194


      Cash paid for interest


      $

      7,360



      $

      6,430









      Supplemental disclosures of non-cash investing and financing activities







      Business acquisition in accounts payable and accrued liabilities



      —




      63,935


      Right-of-use assets obtained in exchange for operating lease liabilities



      5,729




      4,910


      Common stock issued in business combination



      —




      21,952


      Purchase of investments - equity method in accounts payable and accrued liabilities and other liabilities



      —




      9,487


      Draw on letter of credit through Revolver Loan



      —




      4,759


      Dividend paid in the form of common stock



      21,935




      —


      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 (in thousands):



      March 31,




      2025



      2024


      Cash and cash equivalents


      $

      258,517



      $

      334,796


      Restricted cash



      647




      645


      Total cash, cash equivalents, and restricted cash shown in the statement of cash flows


      $

      259,164



      $

      335,441


      Reconciliation of Net Income to EBITDA, Adjusted EBITDA and Adjusted EBITDA Margin

      Set forth below are reconciliations of Net Income to EBITDA and Adjusted EBITDA as well as the reconciliation to Adjusted EBITDA margin for the three months ended March 31, 2025 and 2024. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.



      Three Months Ended
      March 31,



      (in thousands)


      2025




      2024



      Net income


      $

      6,221




      $

      16,862



      Interest expense



      7,308





      7,585



      Interest income



      (2,312)





      (3,996)



      Provision for income taxes



      3,383





      7,142



      Depreciation and amortization



      6,849





      5,096



      EBITDA



      21,449





      32,689












      (Income) loss from equity method investments



      867





      (632)



      Other, net



      6,259


      (1)



      4,440


      (2)

      Stock-based compensation



      7,811





      5,748



      Adjusted EBITDA


      $

      36,386




      $

      42,245












      Total revenue


      $

      620,390




      $

      404,356












      Adjusted EBITDA margin



      6

      %




      10

      %



      (1) Other, net for the three months ended March 31, 2025, relates to debt issuance costs expensed in connection with our Second Amended and Restated Credit Facility, transaction costs for our acquisition of Prospect, data transition costs for our recent acquisitions, certain costs associated with the CHS transaction, non-cash changes related to change in the fair value of our call option and Collar Agreement, and severance fees incurred.

      (2) Other, net for the three months ended March 31, 2024, relates to financial guarantee via a letter of credit that we provided almost three years ago in support of two local provider-led ACOs, non-cash changes related to change in the fair value of our financing obligation to purchase the remaining equity interests in one of our investments, non-cash changes related to change in the fair value of the Company's Collar Agreement, and transaction costs incurred for our investments and tax restructuring fees.

      Guidance Reconciliation of Net Income to EBITDA and Adjusted EBITDA






      2025 Guidance Range


      (in thousands)


      Low



      High


      Net income


      $

      62,500



      $

      73,500


      Interest expense



      16,000




      19,000


      Provision for income taxes



      34,000




      40,000


      Depreciation and amortization



      32,500




      32,500


      EBITDA



      145,000




      165,000









      Income from equity method investments



      (5,500)




      (5,500)


      Other, net



      9,500




      9,500


      Stock-based compensation



      21,000




      21,000


      Adjusted EBITDA


      $

      170,000



      $

      190,000


      The Company has not provided a quantitative reconciliation of EBITDA and Adjusted EBITDA for the quarter ending June 30, 2025 to the most comparable GAAP measure on a forward-looking basis within this press release because the Company is unable, without unreasonable efforts, to provide reconciling information with respect to certain line items that cannot be calculated for the three month period. These items, which could materially affect the computation of forward-looking GAAP net income, are inherently uncertain and depend on various factors, some of which are outside of the Company's control.

      Use of Non-GAAP Financial Measures

      This press release contains the non-GAAP financial measures EBITDA and Adjusted EBITDA, of which the most directly comparable financial measure presented in accordance with U.S. generally accepted accounting principles ("GAAP") is net income. These measures are not in accordance with, or alternatives to GAAP, and may be calculated differently from similar 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 or loss from equity method investments, non-recurring and non-cash transactions, and stock-based compensation. The Company defines Adjusted EBITDA margin as Adjusted EBITDA over total revenue.

      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 business activities without having to account for differences recognized because of non-core or 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 the Company's ongoing operating performance. In addition, these non-GAAP financial measures are among those indicators the Company 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 considered in isolation, or as a substitute for, GAAP financial measures. Other companies may calculate both EBITDA and Adjusted EBITDA differently, limiting the usefulness of these measures for comparative purposes. To the extent 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 non-GAAP measures is provided above.

      SOURCE Astrana Health, Inc.

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