PRIME MEDICAL SERVICES INC /TX/
10-K, 1997-03-27
MISC HEALTH & ALLIED SERVICES, NEC
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_______________________________________________________________________________

                                  UNITED STATES
                       SECURITIES AND EXCHANGE COMMISSION
                             WASHINGTON, D.C. 20549
                              _____________________

                                    FORM 10-K

              [X] Annual Report Pursuant to Section 13 or 15(d) of
                       the Securities Exchange Act of 1934
                   For the fiscal year ended December 31, 1996

            [ ] Transition Report Pursuant to Section 13 or 15(d) of
                       the Securities Exchange Act of 1934
                         For the transition period from
                                  _____ to  _____

                         Commission File Number: 0-22392
                              ___________________

                          PRIME MEDICAL SERVICES, INC.
             (Exact name of registrant as specified in its charter)

       DELAWARE                                        74-2652727
(State or other jurisdiction of                      (I.R.S. Employer
 incorporation or organization)                     Identification No.)

               1301 Capital of Texas Highway, Austin, Texas 78746
               (Address of principal executive offices) (Zip Code)

                                 (512) 328-2892
              (Registrant's telephone number, including area code)

     Check whether the issuer (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. YES___X___    NO  _____

     Check if there is no disclosure  of  delinquent  filers in response to Item
405 of  Regulation  S-K  contained  in  this  form,  and no  disclosure  will be
contained,  to the best of the  registrant's  knowledge,  in definitive proxy or
information statements incorporated by reference in Part III of the Form 10-K or
any amendment to this Form 10-K.

     State the aggregate market value of the voting stock held by non-affiliates
computed by reference  to the price at which the stock was sold,  or the average
bid and asked prices of such stock,  as of a specified date within 60 days prior
to the date of filing. 
          
          Aggregate Market Value at March 20, 1997: $216,678,000

     Indicate the number of shares  outstanding of each of the issuer's  classes
of  common  equity,  as  of  the  latest  practicable  date.  
                                             Number  of  Shares Outstanding  at 
     Title of Each Class                                March 20, 1997 
     -------------------                                --------------
Common Stock,  $.01 par value                             19,260,267

                       DOCUMENTS INCORPORATED BY REFERENCE

     Selected  portions of the  Registrant's  definitive  proxy material for the
1997 annual meeting of shareholders  are incorporated by reference into Part III
of the Form 10-K.

                                        
<PAGE>



                          PRIME MEDICAL SERVICES, INC.

                           ANNUAL REPORT ON FORM 10-K

                      FOR THE YEAR ENDED DECEMBER 31, 1996


                                     PART I

     ITEM 1.  BUSINESS.  
     -------  ---------  

     Prime  Medical  Services,  Inc.,  a Delaware  corporation  ("Prime"  or the
"Company"), through its direct and indirect wholly-owned subsidiaries,  provides
lithotripsy services to hospitals and provides  non-medical  management services
to cardiac rehabilitation centers.

     The Company's  predecessor  corporation  was  organized in April 1972.  The
Company  maintains  its  principal  executive  office at 1301  Capital  of Texas
Highway, Austin, Texas 78746, and its telephone number is (512) 328-2892.

     Unless the context indicates  otherwise,  "Prime" or the "Company" includes
Prime and all of the other  direct and  indirect  wholly-owned  subsidiaries  of
Prime on a consolidated basis.

Lithotripsy Operations
- ----------------------

     The  Company  provides  lithotripsy  services  through  seven  wholly-owned
subsidiaries:  Prime Lithotripsy  Services,  Inc. ("Prime  Lithotripsy"),  Prime
Lithotripter Operations, Inc. ("Prime Lithotripter"), Ohio Litho, Inc. ("Ohio"),
R. R. Litho,  Inc. ("R. R. Litho"),  Texas Litho,  Inc.  ("Texas"),  Sun Medical
Technologies, Inc. ("Sun") and Lithotripters, Inc. Lithotripsy is a non-invasive
procedure  for  the  treatment  of  kidney  stones,  typically  performed  on an
outpatient  basis,  that  eliminates  the need for  lengthy  hospital  stays and
extensive  recovery  periods  associated  with surgery.  Lithotripsy is the only
approved   alternative  to  surgery  for  kidney  stones.   For  these  reasons,
lithotripsy is now the preferred treatment for kidney stones and is suitable for
the treatment of the overwhelming majority of the patients with kidney stones.

     As of March 15,  1997,  the Company  had an economic  interest in 49 mobile
lithotripters and 6 fixed site lithotripters,  all but two of which are operated
by the Company.  The  Company's  lithotripters  serve  hospitals and health care
facilities in 32 states.  The Company provides  non-medical  services related to
the operation of the lithotripters,  including scheduling,  staffing,  training,
quality  assurance,  maintenance,  regulatory  compliance and  contracting  with
payors,  hospitals  and  surgery  centers,  while  medical  care is  rendered by
urologists utilizing the lithotripters.

     The Company  contracts  for its  lithotripsy  services  with  hospitals and
surgery  centers for utilization by urologists  practicing at these  facilities.
The  Company  markets  to  such  facilities  by  providing  well-maintained  and
conveniently  scheduled  equipment  for the use of the  facility's  doctors  and
patients and by providing a full range of  administrative  and support  services
that enable the facility to provide higher quality and more efficient care.

                                        1

<PAGE>



     The Company's service agreements, which generally have terms of one to five
years,  provide  for the three  basic  types of billing  arrangements  described
below.  In all instances,  urologists who perform  lithotripsy  procedures  bill
separately for their professional fees.

     Hospital Billing Contracts - Under a hospital billing contract, the Company
bills and collects from the hospital or surgery center for lithotripsy  services
provided by the Company to patients.  The rates charged under these arrangements
may vary depending upon the number of procedures  performed in a specific period
or category of  patient.  The  hospital  or surgery  center is  responsible  for
billing and collecting from the patient or third-party payor directly.

     True-up  Contracts  - Under a  true-up  contract,  the  Company  bills  and
collects a  negotiated  fee from the hospital or surgery  center,  which is then
retrospectively  reviewed  and adjusted  based on the  payments  received by the
hospital or surgery  center for the  corresponding  treatments.  The hospital or
surgery  center is responsible  for billing and  collecting  from the patient or
third-party payor directly, which forms the basis for any true-up.

     Direct  Billing  Contracts - Under a direct billing  contract,  the Company
bills the  patient or the  patient's  third-party  payor a combined  fee,  which
includes all aspects of the procedure,  excluding the treating  urologist's fee.
The  Company  then pays the  hospital  or  surgery  center a  percentage  of the
collected amount for its services.

Diagnostic Imaging Services
- ---------------------------

     As of December 31, 1994, the Company had terminated its  involvement in its
diagnostic operations.  Prior to that, Prime Diagnostic Services, Inc. and Prime
Diagnostic  Corp.  of Florida,  two  wholly-owned  subsidiaries  of the Company,
provided non-medical management services to diagnostic imaging centers.

Prime Cardiac Rehabilitation Services, Inc.
- -------------------------------------------

     Prime  Cardiac   Rehabilitation   Services,   Inc.  ("Prime  Cardiac"),   a
wholly-owned subsidiary of the Company, provides non-medical management services
for six cardiac rehabilitation centers,  pursuant to agreements with physicians,
clinics and  hospitals  ("Medical  Providers")  for  initial  terms of up to ten
years. The Medical  Providers have absolute  authority over the medical services
provided at the centers,  fees charged to patients and the collection  practices
of the facility.  Prime Cardiac's fees are generally based on collected revenues
of the centers. The Company has substantially reduced its cardiac rehabilitation
business  over the last three  years,  which  accounted  for less than 2% of the
Company's total revenues for the year ended December 31, 1996.

Acquisitions/Divestitures
- -------------------------

     Effective  May 1, 1996,  the Company  acquired  Lithotripters,  Inc.  which
operates  31  lithotripters  in 19 states  through a  network  of 21  affiliated
limited partnerships. Lithotripters, Inc. has an economic interest of 20% to 58%
in each of these  partnerships.  Due to the  significant  control  maintained by
Lithotripters,  Inc. as provided in the  partnership  agreements,  revenues  and
expenses  for  the  partnerships  are  consolidated  and  a  minority   interest
equivalent to the limited partners'  aggregate  ownership  interest is recorded.
The purchase price was $86,500,000  consisting of $71,600,000 cash and 1,636,000
shares of the Company's common stock valued at $14,900,000.

                                        2

<PAGE>





     Effective  October 1, 1995,  the Company  acquired  all of the  outstanding
stock of Sun  Medical  Technologies,  Inc.  which  operates 8  lithotripters  in
California,  Arizona,  Montana, New Mexico, Washington and Wyoming. The purchase
price of  $16,150,000  consisted  of cash paid at closing  equal to  $9,438,000,
seven notes  payable in three years with  original  principal  amounts  totaling
$4,025,000, and $2,687,000 cash paid in January, 1996. Additionally, the Company
issued warrants to purchase  200,000 shares of the Company's  common stock at an
exercise  price  of  $5.99.  The  notes  included  provisions  that  permit  the
noteholders to convert a portion or all of the unpaid principal balance into the
common  stock of the Company at $5.99 per share at each payment  date.  In 1996,
all of the warrants were exercised and the noteholders converted the outstanding
balances of their notes into the Company's stock.

     Effective July 1, 1995, the Company acquired a 70% interest in Kidney Stone
of South Florida,  L.L.C.  which operates a fixed site  lithotripter in the Fort
Lauderdale, Florida area. The purchase price for this interest was $3,885,000 in
cash and a promissory note with a principal amount of $1,665,000. The promissory
note  included a provision  that  permits the  noteholder  to convert all of the
unpaid  principal  balance  into common  stock of the  Company at the  quarterly
payment dates. The noteholder converted the outstanding balance of the note into
the Company's stock in 1996.

     Effective June 1, 1995,  the Company  acquired a 32.5% interest in Southern
California Stone Center, L.L.C., which operates a fixed-site  lithotripter and a
mobile  lithotripter  in the Los  Angeles,  California  area.  The Company  paid
$1,569,000 in cash for this interest.

     Effective  December 31, 1994,  the Company  sold  substantially  all of its
assets  located at an imaging  center in Rancho  Cucamonga,  California  for two
promissory notes with principal  amounts totaling  $1,155,000 and the assumption
of certain contractual obligations.

     Effective  December 30, 1994, the Company sold all of its assets located at
an imaging center in Hemet, California for $260,000 in cash.

     Effective  December 1, 1994, the Company  purchased all of the common stock
of Texas Litho,  Inc., Ohio Litho,  Inc. and R. R. Litho, Inc. from Maxum Health
Corp.  Texas  Litho,  Inc.  is the sole  managing  general  partner  and owns an
approximate 20% interest in Texas ESWL/Laser Lithotripter, Ltd. which operates a
mobile  lithotripter in Texas,  Arkansas and Oklahoma.  Ohio Litho,  Inc. is the
sole  managing  general  partner and owns an  approximate  21%  interest in Ohio
Mobile  Lithotripter,  Ltd. which operates a mobile  lithotripter in Ohio. R. R.
Litho,  Inc. is the sole managing general partner of and owns an approximate 20%
interest in Arklatx Mobile  Lithotripter  Limited  Partnership  which operates a
mobile  lithotripter in Louisiana.  The purchase price paid for the common stock
was $5,007,000 in cash.

     On August 31, 1994,  Shasta  Diagnostic  Center J.V.,  in which the Company
owned a 50% interest,  sold substantially all of the assets of Shasta Diagnostic
Center  located  in  Redding,  California.  The sales  price for the  assets was
$450,000 in cash, a promissory note in the principal amount of $450,000, and the
assumption of certain specified liabilities.



                                        3

<PAGE>

     Effective August 15, 1994, the Company sold substantially all of the assets
of Tower Diagnostic  Center located in Tampa,  Florida.  The sales price for the
assets was  $2,350,000  in cash, a promissory  note in the  principal  amount of
$500,000 and the assumption of certain specified liabilities.

     Effective  August 1, 1994, the Company  acquired  substantially  all of the
assets of Alabama Lithotripsy Joint Venture, an Alabama general partnership. The
partnership  operated  a mobile  lithotripter  in Alabama  which it leased  from
Baptist  Medical  Center-Montclair.   In  a  related  transaction,  the  Company
purchased the  lithotripter  for a promissory  note in the  principal  amount of
$316,000.  The purchase price for the assets of the joint venture was $2,863,000
in cash,  a  promissory  note in the  principal  amount of  $2,304,000,  a stock
purchase  warrant  covering  725,000  shares  of  common  stock  of the  Company
exercisable at $3.18 per share and the assumption of certain  liabilities of the
joint venture. In 1996, the warrants were exercised and the note was paid off.

     In July 1994, the Company  purchased all of the outstanding  capital stock
of Alabama Renal Stone Institute, Inc., an Alabama corporation, which operates a
fixed site lithotripter  located in Birmingham,  Alabama. The Company previously
operated  this  lithotripter  through a  license  agreement  which was  canceled
concurrent  with the  acquisition.  The purchase price for this  acquisition was
$3,000,000  cash paid in 1994,  along with an option  issued in 1992 for 210,000
shares of the Company's common stock,  and an additional  payment of $895,000 in
August, 1995.

     Effective  April 1, 1994,  the  Company  acquired a 60%  interest  in Metro
Atlanta Stonebusters, G.P., a Texas general partnership, which operates a mobile
lithotripter operating in the Atlanta, Georgia area. The purchase price for this
acquisition  was $2,040,000 in cash and a promissory  note issued by the Company
in an original principal amount of $3,700,000 bearing interest at 6% per year.

     In January 1994, the Company acquired all of the outstanding  capital stock
of Fazio Consulting, Inc. ("FCI"), a New Jersey corporation, which owns 2 mobile
lithotripters operating in Delaware, Illinois, Indiana, Maryland,  Pennsylvania,
West  Virginia,  and  Wisconsin.  The purchase  price for this  acquisition  was
$950,000 in cash, the repayment of two promissory  notes of FCI in the aggregate
amount of $1,100,000  and an earnout for the next five years based on 50% of the
annual  net  income of FCI.  In March,  1995,  the  Company  paid an  additional
$560,000 for the 1994 earnout.  In January,  1996,  the Company  terminated  the
earnout agreement for $500,000 in cash.

     The Company had a 1%  ownership  interest  in American  Physicians  Service
Group, Inc. ("APS") at December 31, 1995 and 1996 and a 22% interest at December
31, 1994. The Company intends to divest the remaining 1% ownership interest.

Potential Liabilities-Insurance
- -------------------------------

     All medical procedures  performed in connection with the Company's business
activities are conducted  directly by, or under the supervision of,  urologists,
cardiologists  and other physicians,  who are not employees of the Company.  The
Company does not provide  medical  services to any patients.  However,  patients
being  treated at health  care  facilities  at which the  Company  provides  its
non-medical  services  could  suffer a medical  emergency  resulting  in serious
injury or death, which could subject the Company to the risk of lawsuits seeking
substantial damages.

                                        4

<PAGE>

     The  Company  currently   maintains  general  and  professional   liability
insurance with a total limit of $1,000,000 per loss event and $3,000,000  policy
aggregate  and an umbrella  excess limit of  $10,000,000,  with a deductible  of
$25,000 per occurrence.  In addition, the Company requires medical professionals
who utilize its services to maintain  professional  liability insurance.  All of
these insurance policies are subject to annual renewal by the insurer.  If these
policies  were to be canceled or not  renewed,  or failed to provide  sufficient
coverage  for  the  Company's  liabilities,  the  Company  might  be  forced  to
self-insure against the potential  liabilities referred to above. In that event,
a single  incident  might  result  in an award of  damages  which  might  have a
material adverse effect on the operations of the Company.

Governmental Regulation and Associated Risks
- --------------------------------------------

     The  Company  is  subject  to  extensive  regulation  by both  the  federal
government  and the  states in which the  Company  conducts  its  business.  The
Company is subject to  Section  1128B of the Social  Security  Act (known as the
"Illegal Remuneration  Statute"),  which imposes civil and criminal sanctions on
persons  who  solicit,  offer,  receive  or pay any  remuneration,  directly  or
indirectly,  for  referring,  or  arranging  for the  referral of, a patient for
treatment that is paid for in whole or in part by Medicare,  Medicaid or similar
government  programs.  The federal  government  has published  regulations  that
provide  exceptions  or "a  safe  harbor"  for  certain  business  transactions.
Transactions  that are  structured  within  the safe  harbors  are deemed not to
violate the Illegal Remuneration  Statute.  Transactions that do not satisfy all
elements  of a relevant  safe  harbor do not  necessarily  violate  the  Illegal
Remuneration  Statute,  but may be subject to greater  scrutiny  by  enforcement
agencies.  The  arrangements  between the Company and the partnerships and other
entities in which it owns an  indirect  interest  and through  which the Company
provides most of its lithotripsy  services (and the  corresponding  arrangements
between such partnerships and other entities and the treating physicians who own
interests  therein  and  who  use  the  lithotripsy  facilities  owned  by  such
partnerships  and other  entities)  could  potentially  be questioned  under the
illegal remuneration prohibition and may not fall within the protection afforded
by these safe harbors. Many states also have laws similar to the Federal Illegal
Remuneration Statute.  While failure to fall within the safe harbors may subject
the Company to scrutiny  under the Illegal  Remuneration  Statute,  such failure
does not constitute a violation of the Illegal Remuneration Statute.

     In addition to the Illegal Remuneration Statute, Section 1877 of the Social
Security Act ("Stark II") imposes certain restrictions upon referring physicians
and  providers  of certain  designated  health  services  under the Medicare and
Medicaid programs.  Subject to certain  exceptions,  Stark II provides that if a
physician (or a family member of a physician) has a financial  relationship with
an  entity;  (i) the  physician  may not make a  referral  to the entity for the
furnishing of designated  health  services  reimbursable  under the Medicare and
Medicaid  programs,  and (ii) the entity may not bill  Medicare,  Medicaid,  any
individual or any third-party  payor for designated  health  services  furnished
pursuant to a prohibited referral.  Entities and physicians committing an act in
violation of Stark II are subject to civil money  penalties and  exclusion  from
the  Medicare  and  Medicaid  programs.  Although  lithotripsy  services are not
specifically  identified  as a  designated  health  service  in  Stark  II,  the
restrictions do apply to inpatient and outpatient hospital services. Lithotripsy
services provided by the Company to Medicare and Medicaid patients are billed by
the contracting hospital in its name and under its Medicare and Medicaid program
provider numbers. Therefore, while the lithotripsy services could be considered 

                                                         5

<PAGE>

inpatient/outpatient   hospital   services  subject  to  the  self-referral
restrictions  contained in Stark II, the Company  believes that the language and
legislative  history of Stark II indicate  that  Congress did not intend for the
restrictions  contained  therein  to  apply to  ownership  of  interests  in the
partnerships and other entities through which the Company's lithotripsy services
are provided.

     It is unclear  whether one of the  enumerated  exceptions to Stark II would
apply if  lithotripsy  services  are  considered  inpatient/outpatient  hospital
services  when billed by a hospital.  A complete  regulatory  interpretation  of
Stark  II will  only  be  available  upon  publication  of the  final  Stark  II
regulations.  Additionally,  it is unclear to what extent these  regulations may
address issues regarding the Company's  relationships with physician  investors.
Publication of these regulations could affect the Company's  relationships  with
physician investors and have a materially adverse effect upon the Company.

     In addition, many states have enacted similar legislation.

     Some states require approval,  usually in the form of a certificate of need
("CON"),   prior  to  the  purchase  of  major  medical  equipment  exceeding  a
predesignated  capital expenditure  threshold or for the commencement of certain
clinical health services.  Such approval is generally based upon the anticipated
utilization  of the  service  and the  projected  need  for the  service  in the
relevant geographical area of the state where the service is to be provided. CON
laws  differ in many  respects,  and not every  state's  CON law  applies to the
Company.  Most of the  Company's  operations  originated in states which did not
require a CON for  lithotripsy  services,  and the Company has obtained a CON in
states  where  one  is  required.  Some  states  also  require  registration  of
lithotripters  with the state agency  which  administers  its CON program.  Such
registration  is  not  subject  to  any  required  approval,  but  rather  is an
administrative  matter  imposed so that the state will be aware of all  existing
clinical health  services.  The Company  registers in those states which require
these filings.

     All  states in which  the  Company  operates  require  registration  of the
fluoroscopic  x-ray tubes which are utilized to locate the kidney stones treated
with the Company's lithotripters.  The registration  requirements are imposed in
order to facilitate periodic inspection of the fluoroscopic tubes.

     Some  states  have  regulations  that  require  facilities  such as  mobile
lithotripters  to be licensed and to have  appropriate  emergency care resources
and qualified staff meeting the stated educational and experience criteria.  The
Company's lithotripsy equipment is subject to regulation by the U.S. Food & Drug
Administration,  and the motor  vehicles  utilized to  transport  the  Company's
mobile  lithotripsy  equipment  are  subject  to safety  regulation  by the U.S.
Department of  Transportation  and the states in which the Company  conducts its
mobile  lithotripsy  business.  The  Company  believes  that  it is in  material
compliance with these regulations.


                                        6

<PAGE>



     While the Company  believes it complies in all material  respects  with the
foregoing   laws  and   regulations,   and  all  other   applicable   regulatory
requirements,  these laws are complex and have been broadly  construed by courts
and enforcement agencies.  Thus, there can be no assurance that the Company will
not be required to change its  practices  (or its  relationships  with  treating
physicians holding minority interests in partnerships and other entities through
which  the  Company  provides  most of its  lithotripsy  services),  or that the
Company  will  not  experience  material  adverse  effects  as a  result  of any
investigations or enforcement actions by a federal or state regulatory agency.

     A number of  proposals  for  health  care  reform  have been made in recent
years,  some of which have included  radical  changes in the health care system.
Health  care  reform  could  result in  material  changes in the  financing  and
regulation of the health care business, and the Company is unable to predict the
effect  of  such  changes  on  its  future  operations.  It  is  uncertain  what
legislation  on health care reform,  if any, will  ultimately be  implemented or
whether other changes in the  administration  or  interpretation of governmental
health care  programs will occur.  There can be no assurance  that future health
care legislation or other changes in the  administration  or  interpretation  of
governmental health care programs will not have a material adverse effect on the
results of operations of the Company.

Equipment
- ---------

     The  Company  purchases  its  lithotripter  equipment  and  maintenance  is
generally  provided pursuant to service contracts with the manufacturer or local
service companies.  The cost of a new lithotripter is approximately  $1,200,000.
For mobile  lithotripsy,  the Company  either  purchases  or leases the tractor,
usually  for a term  up to five  years,  and  purchases  the  trailer  or a self
contained coach.

Employees
- ---------

     As of March 15, 1997,  the Company  employed  approximately  250  full-time
employees and approximately 20 part-time employees.

Competition
- -----------

     The  market  to  provide  lithotripsy  services  is highly  fragmented  and
competitive.  The Company  competes  with other private  facilities  and medical
centers  that  offer  lithotripsy  services  and  with  hospitals,  clinics  and
individual medical  practitioners that offer conventional  medical treatment for
kidney stones.  Certain of the Company's current and potential  competitors have
substantially  greater financial resources than the Company and may compete with
the Company for  acquisitions  and development of operations in markets targeted
by the Company.

     There are numerous  physicians,  hospitals,  clinics, and other groups that
own, operate and manage cardiac rehabilitation  centers. The primary competitive
factors in this  industry  are price,  professional  services  offered,  and the
equipment located at the facility.






                                        7

<PAGE>



ITEM 2.           PROPERTIES.
- -------           -----------

     The Company's principal executive office is located in Austin,  Texas in an
office  building  owned by APS.  The Company pays APS  approximately  $4,000 per
month,  which  includes  rental payment for  approximately  2,800 square feet of
office space,  reception and telephone services,  and certain other services and
facilities. The office space lease expires in December, 1997.

     The Company  leases  approximately  11,000  square feet of office  space in
Fayetteville,  NC under two leases  expiring in 2001. The current  monthly lease
amount is approximately $10,000.

     The Company  leases  approximately  5,700  square  feet of office  space in
Campbell,  California under a five year lease which expires in 1997. The current
monthly lease amount is approximately $10,000.



ITEM 3.           LEGAL PROCEEDINGS.
- -------           ------------------
                  NONE.

ITEM 4.           SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS.
- -------           ----------------------------------------------------
                  NONE.

                                     PART II


ITEM 5.           MARKET FOR REGISTRANT'S COMMON STOCK AND RELATED STOCKHOLDER 
                  MATTERS.
- ------            -------------------------------------------------------------

     The  following  table  sets forth the high and low  closing  prices for the
Company's  common  stock  in the  over-the-counter  market  as  reported  by the
National  Association of Securities Dealers,  Inc., Automated Quotations System,
for the years ended December 31, 1996 and 1995 (NASDAQ Symbol "PMSI").


              Year Ended December 31, 1996           High         Low
              ----------------------------           ----         ----
              First Quarter                    $    13.31   $     6.75
              Second Quarter                        20.38        13.06
              Third Quarter                         17.25        11.00
              Fourth Quarter                        13.75        10.00

              Year Ended December 31, 1995           High         Low
              ----------------------------           ----         ----
              First Quarter                    $     4.00   $     3.25
              Second Quarter                         4.94         3.38
              Third Quarter                          4.88         4.06
              Fourth Quarter                         9.13         4.63

                                        8

<PAGE>



     On March 20, 1997, the Company had  approximately  890 holders of record of
its common stock.

     The Company has not declared any cash  dividends on its common stock during
the last two years and has no present  intention of declaring any cash dividends
in the  foreseeable  future.  In addition,  the Company is not  permitted by its
current credit facility to declare or make any payments for dividends. It is the
present policy of the Board of Directors to retain all earnings to provide funds
for the growth of the Company.  The  declaration and payment of dividends in the
future will be  determined  by the Board of Directors  based upon the  Company's
earnings,  financial condition,  capital  requirements,  loan covenants and such
other factors as the Board of Directors may deem relevant.


                                        9

<PAGE>




ITEM 6.  SELECTED FINANCIAL DATA.
- -------  ------------------------

($ in thousands, except per share data)
<TABLE>
<CAPTION>


                                                                Years Ended December 31,
                                          1996           1995           1994           1993           1992
                                       ----------     ----------     ----------     ----------     ----------
<S>                                    <C>            <C>            <C>            <C>            <C>

Revenues:

Lithotripsy                            $   71,602     $   22,153     $   14,843     $    7,309     $    4,291

Imaging and cardiac                           802          1,042          9,925         13,259         15,026
                                       ----------     ----------     ----------     ----------     ----------

Continuing operations                  $   72,404     $   23,195     $   24,768     $   20,568     $   19,317
                                       ==========     ==========     ==========     ==========     ==========


Income:

Net income                             $    8,961     $    7,204     $    4,504     $    2,539     $    1,592
                                       ==========     ==========     ==========     ==========     ==========


Fully diluted earnings per share:

Net income                             $     0.48     $     0.46     $     0.31     $     0.21     $     0.17
                                       ==========     ==========     ==========     ==========     ==========


Dividends per share                       None           None           None           None           None


Total assets                           $  197,753     $   77,627     $   53,861     $   38,678     $   22,349
                                       ==========     ==========     ==========     ==========     ==========

Long-term obligations                  $   70,910     $   22,323     $   12,734     $    2,675     $    3,921
                                       ==========     ==========     ==========     ==========     ==========
</TABLE>

                                                                 10

<PAGE>



ITEM 7.           MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL
                  CONDITION AND RESULTS OF OPERATIONS.
- -------           --------------------------------------------------

Year ended December 31, 1996 compared to the year ended December 31, 1995
- --------------------------------------------------------------------------

Revenues
- ---------

     Total revenues increased  $49,209,000 (212%) as compared to the same period
in  1995.  Revenues  from  lithotripter   operations  increased  by  $49,449,000
primarily  due to the  acquisition  of (1) an entity  that  owned or  managed 31
lithotripters  effective  May 1,  1996 (2) an  entity  that  owned or  managed 8
lithotripters  effective  October 1, 1995,  and (3) a 70%  interest in an entity
that operated one  lithotripter,  as of July 1, 1995.  In addition,  the Company
acquired a 32.5%  interest in an entity that operated one  lithotripter  in June
1995.  Revenues from cardiac centers  decreased  $240,000  primarily due to four
discontinued/sold cardiac centers.

Expenses
- --------

     Costs and expenses  decreased  from 43% to 34% of revenues,  but  increased
$14,742,000 (147%) in absolute terms, compared to the same period in 1995. Costs
of services associated with lithotripter operations increased $13,943,000 (233%)
in absolute terms and from 27% to 28% of lithotripter  revenues primarily due to
the  acquisitions  discussed  above.  Cost of services  associated  with cardiac
centers decreased $873,000 (58%) primarily due to four discontinued/sold cardiac
centers.  Corporate expenses decreased from 11% to 6% of revenues as the Company
was able to successfully grow without proportionately adding overhead. Corporate
expenses  increased  $1,672,000 (65%) primarily due to the additional  corporate
expenses  associated  with the  acquisition  discussed  above and the management
incentive plans tied to the performance of the Company.

Other Income (Deductions)
- -------------------------

     Other deductions increased $8,251,000 primarily due to (1) the write-off of
$2,735,000  in fees paid to lenders to obtain  financing,  and  $800,000 in fees
associated with a proposed stock offering that was canceled in August, 1996, and
(2) interest expense  increased  $4,746,000 due to $74,000,000 in new borrowings
in 1996 primarily for the acquisition of  Lithotripters,  Inc.  effective May 1,
1996.


Minority Interest In Consolidated Income
- ----------------------------------------

     Minority interest in consolidated  income increased  $19,089,000  primarily
due to the  minority  interest  associated  with  the 21  partnerships  in which
Lithotripters,  Inc. holds a controlling  interest.  The Company acquired all of
the stock of Lithotripters, Inc. effective May 1, 1996.



                                       11

<PAGE>


Year ended December 31, 1995 compared to the year ended December 31, 1994
- --------------------------------------------------------------------------

Revenues
- --------

     Total revenues decreased in 1995 by $1,573,000 (6%) compared to 1994, as an
increase in revenues  from  lithotripsy  operations  was more than offset by the
Company's exit from the diagnostic  imaging business.  Revenues from lithotripsy
operations  increased by $7,310,000 (49%) primarily due to the acquisition of 10
additional  lithotripter  operations in 1995 ($3,499,000) and the recognition of
revenues  for a full  year  of  operations  from  five  lithotripter  operations
acquired  during 1994  ($3,942,000).  Revenues from cardiac and imaging  centers
declined by $8,883,000  due primarily to the Company's  exit from the diagnostic
imaging business at the end of 1994.

Costs and Expenses
- ------------------

     Costs and expenses in 1995 declined by $5,220,000  (34%)  compared to 1994,
from 62% to 43% of  revenues.  Costs of  services  associated  with  lithotripsy
operations  decreased  from 29% to 27% of lithotripsy  revenues,  as the Company
recognized   operating   efficiencies   resulting  from  the   acquisition   and
consolidation of additional  lithotripsy  operations.  In absolute terms,  these
costs  increased by  $1,696,000  (40%)  primarily due to the  acquisition  of 10
additional lithotripter operations in 1995 ($1,271,000) and the full year effect
of the five lithotripsy  operations  acquired during 1994 ($542,000),  partially
offset by a decline in costs associated with lithotripsy  operations open during
both years  ($117,000).  Costs of services  from  cardiac  and  imaging  centers
decreased by  $7,075,000  (82%)  primarily  due to the  Company's  exit from the
diagnostic imaging business at the end of 1994.  Corporate expenses increased by
$159,000  (7%) from 10% to 11% of total  revenues  primarily  due to  management
incentive plans tied to the performance of the Company.

Other Income/Deductions
- -----------------------

     Other  deductions  decreased  by $342,000.  Interest  and  dividend  income
decreased by $67,000 (31%)  primarily due to less cash  available for investment
due to cash being utilized to acquire lithotripsy  operations.  Interest expense
increased  by  $329,000   (36%)  as  a  result  of  increased  debt  related  to
acquisitions.  Other  income  increased  by $738,000  primarily  due to the gain
recognized on the sale in the open market of stock of APS ($559,000),  which was
being held for investment purposes.

Minority Interest In Consolidated Income
- ----------------------------------------

     Minority interest in consolidated  income increased  $730,000 primarily due
the minority  interest in a fixed site  lithotripter  that  operated in the Fort
Lauderdale,  Florida area. The Company acquired a 70% interest in this operation
effective July 1, 1995.


                                       12

<PAGE>

Liquidity and Capital Resources
- --------------------------------

     The Company's cash was  $20,096,000 and $4,692,000 at December 31, 1996 and
1995, respectively. Cash provided by operations for the years ended December 31,
1996  and 1995 was  $40,034,000  and  $10,898,000,  respectively.  Cash  used in
investing activities for the year ended December 31, 1996 was $70,202,000.  This
was primarily due to  expenditures of $68,561,000  associated with  acquisitions
and  $2,526,000 for the purchase of equipment and leasehold  improvements  to be
used in the Company's  operations  which  expenditures  were partially offset by
$1,257,000  in  distributions  from  investments.  Cash  provided  by  financing
activities  for the year  ended  December  31,  1996 was  $45,572,000  which was
primarily due to $74,000,000 of borrowings  under credit  facilities,  partially
offset by payments in the amount of $15,351,000 on notes payable and payments to
minority interests of $13,440,000.  The Company's line of credit has a borrowing
limit of $40,000,000. At December 31, 1996, $29,750,000 was drawn on the line of
credit.

     The Company  believes that its present cash  position,  together with funds
generated from operations,  will provide  sufficient  resources to meet its cash
requirements for current operations and repay existing debt. The Company intends
to  continue  its  growth  strategy  in the future  and  expects  to  facilitate
additional acquisitions through the issuance of common stock and debt financing.

     The Company  anticipates that capital  expenditures for new and replacement
equipment in 1997 will be approximately  $3,000,000,  the majority of which will
be financed through operating cash flow.

Impact of Inflation
- --------------------

     The assets of the  Company  are not  significantly  affected  by  inflation
because, having no manufacturing operations, the Company is not required to make
large  investments in fixed assets.  However,  the rate of inflation will affect
certain of the Company's expenses, such as employee compensation and benefits.


ITEM 8.           FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA.
- -------           --------------------------------------------

     The  information  required by this item is contained in Appendix A attached
hereto.


ITEM 9.           CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON
                  ACCOUNTING AND FINANCIAL DISCLOSURE.
- -------           --------------------------------------------------

     NONE.


                                       13

<PAGE>



                                    PART III


ITEM 10.          DIRECTORS AND EXECUTIVE OFFICERS OF THE REGISTRANT.
- --------          ---------------------------------------------------

     The information  required by this item is contained in the definitive proxy
material of the Company to be filed in connection  with its 1997 annual  meeting
of shareholders,  except for the information regarding executive officers of the
Company which is provided below. The information required by this item contained
in such definitive proxy material is incorporated herein by reference.

EXECUTIVE OFFICERS OF THE REGISTRANT.
- -------------------------------------

     As of March 15, 1997, the executive officers of the Company are as follows:

  Name                        Age         Position
  ----                        ---         --------
Kenneth S. Shifrin             47       Chairman of the Board

Joseph Jenkins, M.D., J.D.     49       President, Chief Executive Officer
and Director

Dan Myers, M.D.                42       Senior Vice President - Development

Michael Madler                 38       Senior Vice President of Operations

Stan Johnson                   43       Vice President

Cheryl L. Williams             45       Chief Financial Officer, 
                                        Vice President-Finance, and Secretary



     The   foregoing   does  not  include   positions   held  in  the  Company's
subsidiaries.  Officers  are  elected  for annual  periods.  There are no family
relationships  between any of the  executive  officers  and/or  directors of the
Company.

Mr. Shifrin
- -----------

     Mr.  Shifrin  has been  Chairman of the Board and a Director of the Company
since October 1989. In addition,  Mr.  Shifrin has served in various  capacities
with APS since February  1985, and is currently  Chairman of the Board and Chief
Executive Officer of APS.


                                       14

<PAGE>



Dr. Jenkins
- -----------

     Dr. Jenkins has been President and Chief  Executive  Officer and a Director
of the Company since April 1996.  From May 1990 until December 1991, Dr. Jenkins
was a Vice President of Lithotripters,  Inc. Since January 1992, Dr. Jenkins has
been President of Lithotripters, Inc. Dr. Jenkins is a board certified urologist
and is a founding member, the immediate  past-president and currently a director
of the American Lithotripsy Society.

Dr. Myers
- ---------

     Dr. Myers has been Senior Vice President - Development of the Company since
August 1996. Dr. Myers is a board  certified  urologist and was a Vice President
of Lithotripters, Inc. from January 1990 until it was acquired by the Company in
April 1996.

Mr.  Madler  
- ----------  

     Mr. Madler has been Senior Vice President - Operations of the Company since
August 1996.  From July 1993 to August  1996,  Mr.  Madler was Vice  President -
Operations  of  the  Company.  Previously  Mr.  Madler  was  Vice  President  of
Operations of American Health Services Corp., a diagnostic imaging company, from
July 1991 to June 1993.  He was employed by the Company from 1985 to 1991,  most
recently as its Vice President - Operations.

Mr. Johnson
- -----------

     Mr.  Johnson has been a Vice President of the Company and President of Sun,
a subsidiary of the Company,  since  November  1995.  Mr.  Johnson was the Chief
Financial Officer of Sun from 1990 to 1995.

Mrs. Williams
- -------------

     Mrs.  Williams  has  been  Chief  Financial  Officer,  Vice  President  and
Secretary of the Company  since October 1989.  Mrs.  Williams was  Controller of
Fairchild  Aircraft  Corporation  from August 1988 to October 1989. From 1985 to
1988, Mrs. Williams served as the Chief Financial Officer of APS Systems,  Inc.,
a wholly-owned subsidiary of APS.


ITEM 11.          EXECUTIVE COMPENSATION.
- --------          -----------------------
  
     The information  required by this item is contained in the definitive proxy
statement of the Company to be filed in connection  with its 1997 annual meeting
of shareholders, which information is incorporated herein by reference.



                                       15

<PAGE>




ITEM 12.          SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND
                  MANAGEMENT.
- --------          ----------------------------------------------------

     The information  required by this item is contained in the definitive proxy
statement of the Company to be filed in connection  with its 1997 annual meeting
of shareholders, which information is incorporated herein by reference.


ITEM 13.          CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS.
- --------          -----------------------------------------------

     The information  required by this item is contained in the definitive proxy
statement of the Company to be filed in connection  with its 1997 annual meeting
of shareholders, which information is incorporated herein by reference.


                                     PART IV

ITEM 14.          EXHIBITS, FINANCIAL STATEMENT SCHEDULES, AND REPORTS ON
                  FORM 8-K.
- --------          --------------------------------------------------------
  
(a)      1.       Financial Statements.
                  ---------------------

     The  information  required by this item is contained in Appendix A attached
hereto.

         2.       Financial Statement Schedules.
                  ------------------------------

     II - Valuation and  Qualifying  Accounts as of December 31, 1996,  1995 and
1994.

     All other schedules are omitted as the required information is presented in
the Consolidated Financial Statements and related notes.

(b)      Reports on Form 8-K.
         -------------------- 

     None.

         Exhibits. (1)
         ---------
         3.1       Certificate of Incorporation of the Company. (2)

         3.2       Bylaws of the Company. (2)

         4.1       Specimen of Common Stock Certificate. (2)

         10.1*     Prime Medical Services, Inc. 1993 Stock Option Plan. (3)


                                       16

<PAGE>



         10.2      Rights Agreement dated October 18, 1993 between the Company 
                   and American Transfer and Trust Company. (3)

         10.3      Form of Indemnification Agreement dated October 11, 1993 
                   between the Company and certain of its officers and 
                   directors. (3)

         10.4      Contribution Agreement among Metro Atlanta Stonebusters, 
                   Inc., Prime Lithotripsy Services, Inc. and Metro Atlanta 
                   Stonebusters, G.P. dated April 26, 1994. (6)

         10.5      Partnership Agreement of Metro Atlanta Stonebusters, G.P. (6)

         10.6      Promissory Note of Prime Lithotripsy Services, Inc. dated 
                   April 26, 1994. (6)

         10.7      Stock Purchase and Amendment Agreement dated July 28, 1994 
                   by and among A. Derrill Crowe, Paul R. Butrus, the Company, 
                   the Alabama Renal Stone Institute, Inc., Alabama Kidney 
                   Stone Foundation, Inc., American Physicians Service Group, 
                   Inc. and A. Derrill Crowe and Paul R. Butrus as Trustees of 
                   the A. Derrill Crowe Revocable Trust and the Paul R. Butrus 
                   Trust. (7)

         10.8      Management Agreement dated July 28, 1994 between the Alabama 
                   Renal Stone Institute, Inc. and Alabama Kidney Stone 
                   Foundation, Inc. (7)

         10.9      Asset Purchase Agreement, dated August 30, 1994, between     
                   Prime Lithotripter Operations, Inc. and Alabama Lithotripsy 
                   Joint Venture. (8)

         10.10     Asset Purchase Agreement, dated August 30, 1994, between 
                   Prime Lithotripter Operations, Inc. and Baptist Medical 
                   Center - Montclair. (8)

         10.11     Promissory Note, dated August 30, 1994, issued by Prime 
                   Lithotripter Operations, Inc. to Baptist Medical Center - 
                   Montclair.  (8)

         10.12     Management Agreement, dated August 30, 1994, between Prime
                   Lithotripter Operations, Inc. and Alabama Lithotripsy 
                   Associates, Inc.  (8)

         10.13     Security Agreement dated August 30, 1994, between Prime 
                   Lithotripter Operations, Inc. and Baptist Medical Center - 
                   Montclair.  (8)

         10.14     Asset Purchase Agreement dated August 15, 1994 between 
                   Radiology Associates of Tampa, P.A. and Prime Diagnostic 
                   Corp. of Florida.  (9)

         10.15     Stock Purchase Agreement dated December 19, 1994 between the
                   Company, Maxum Health Corp. And Maxum Health Services Corp.  
                   (10)

                                       17

<PAGE>



         10.16     Asset Purchase Agreement dated December 23, 1994 by and among
                   MedQuest Associates, Inc., Grove Diagnostic Imaging Center, 
                   Inc. and Prime Diagnostic Services, Inc.  (10)

         10.17     Amended and Restated Joint Venture Agreement dated April, 
                   1989, between Prime Diagnostic Imaging Services, Inc. and 
                   The Shasta Diagnostic Imaging Medical Group. (5)

         10.18     Contract of Sale of Business between Shasta Diagnostic 
                   Center, J.V., Shasta Diagnostic Imaging Services, Inc. and 
                   Michael G. Davis dated September 1, 1994.  (11)

         10.19     Promissory Note of Shasta Diagnostic Imaging Services, Inc. 
                   and Michael G. Davis dated September 1, 1994.  (11)

         10.20     Loan Agreement dated November 28, 1994 between Prime Medical
                   Services, Inc., The First National Bank of Boston, 
                   NationsBank of Texas, N.A. and The First National Bank of 
                   Boston, as agent.  (11)

         10.21     First Amendment to Loan Agreement dated August 17, 1995 
                   between Prime Medical Services, Inc. And The First National 
                   of Boston, as agent. (13)

         10.22     Amended and Restated Loan Agreement dated April 26, 1996 
                   between Prime Medical Services, Inc., The First National Bank
                   of Boston, NationsBank of Texas, N.A. and The First National 
                   Bank of Boston, as agent. (15)

         10.23     Promissory Note, dated April 26, 1996 issued by the Company 
                   to the First National Bank of Boston.  (15)

         10.24     Promissory Note, dated April 26, 1996 issued by the Company 
                   to NationsBank of Texas, N.A.  (15)

         10.25     Promissory Note, dated April 26, 1996 issued by the Company 
                   to the First National Bank of Boston.  (15)

         10.26     Promissory Note, dated April 26, 1996 issued by the Company 
                   to NationsBank of Texas, N.A.  (15)

         10.27     Contribution Agreement among Southern California Stone 
                   Center, A Medical Group, Prime Lithotripsy Services, Inc., 
                   and Southern California Stone Center, L.L.C. dated June 1, 
                   1995.  (13)
       
                                       18

<PAGE>

        
         10.28     Operating Agreement for Southern California Stone Center, 
                   L.L.C.  (13)

         10.29     Contribution Agreement among Kidney Stone Center of South 
                   Florida, Ltd., South Florida Lithotripters, Ltd., Prime 
                   Lithotripsy Services, Inc. and Kidney Stone Center of South 
                   Florida, L.C. dated August 24, 1995. (13)

         10.30     Lease Agreement dated July 1, 1995 between Kidney Stone 
                   Center of South Florida, L.C. and Madorsky and Pinon Kidney 
                   Stone Center of South Florida, P.A.  (13)

         10.31     Stock Purchase Agreement with respect to all Outstanding 
                   Capital Stock of Sun Medical Technologies, Inc. dated 
                   November 10, 1995.  (12)

         10.32*    Employment Agreement dated October 27, 1995 between Prime 
                   Medical Services, Inc. And Stan D. Johnson.  (13)

         10.33*    Employment Agreement dated May 1, 1996 between Prime Medical
                   Services, Inc. and Joseph Jenkins, M.D., J.D. (15)

         10.34     Stock Purchase Agreement dated April 26, 1996 between Prime 
                   Medical Services, Inc.; Lithotripters, Inc.; William R. 
                   Jordan, M.D.; Franklin S. Clark, M.D.; Dan A. Myers, M.D.; 
                   Thomas B. Mobley, M.D.; Thomas R. Jordan; Anthony E. Rand; 
                   Estate of H. Edward Rietze, III; Phillip J. Gallina; Joseph 
                   Jenkins, M.D.; William B. Grine, M.D.; and W. Alan Terry. 
                   (14)

         10.35     Registration Rights Agreement dated April 26, 1996 between 
                   Prime Medical Services, Inc.; Lithotripters, Inc.; William R.
                   Jordan, M.D.; Franklin S. Clark, M.D.; Dan A. Myers, M.D.; 
                   Thomas B. Mobley, M.D.; Thomas R. Jordan; Anthony E. Rand; 
                   Estate of H. Edward Rietze, III; Phillip J. Gallina; Joseph 
                   Jenkins, M.D.; William B. Grine, M.D.; and W. Alan Terry. 
                   (14)

         10.36     Stock Purchase Agreement dated April 26, 1996 between Prime 
                   Medical Services, Inc. and FastStart, Inc.; Lithotripters, 
                   Inc.; William R. Jordan, M.D.; Franklin S. Clark, M.D.; Dan 
                   A. Myers, M.D.; Thomas B. Mobley, M.D.; Thomas R. Jordan; 
                   Anthony E. Rand; Estate of H. Edward Rietze, III; Phillip J. 
                   Gallina; Joseph Jenkins, M.D.; William B. Grine, M.D.; and 
                   W. Alan Terry. (14)


                                       19

<PAGE>

         11.1      Computation of per share earnings (included in Appendix A 
                   hereto).

         21.1      List of subsidiaries of the Company.  (15)


         23.1      Independent Auditors' Consent of KPMG Peat Marwick LLP. (15)
 --------------

         *        Executive compensation plans and arrangements.

     (1) The exhibits listed above will be furnished to any security holder upon
written request for such exhibit to Cheryl L. Williams,  Prime Medical Services,
Inc., 1301 Capital of Texas Highway, Austin, Texas 78746.

     (2)  Filed  as an  Exhibit  to  the  Registration  Statement  on  Form  S-4
(Registration No. 33-56900) of the Company and incorporated herein by reference.

     (3) Filed as an Exhibit to the  Current  Report on Form 8-K of the  Company
dated October 18, 1993 and incorporated herein by reference.

     (4) Filed as an  Exhibit  to the  Annual  Report on Form 10-K of Old Prime,
Commission  File  Number  0-9963,  for the  year  ended  December  31,  1990 and
incorporated herein by reference.

     (5) Filed as an  Exhibit  to the  Annual  Report on Form 10-K of Old Prime,
Commission  File  Number  0-9963,  for the  year  ended  December  31,  1992 and
incorporated herein by reference.

     (6) Filed as an Exhibit to the Current Report on Form 8-K dated May 5, 1994
of the Company and incorporated herein by reference.

     (7) Filed as an  Exhibit to the  Current  Report on Form 8-K dated July 28,
1994 of the Company and incorporated herein by reference.

     (8) Filed as an Exhibit to the Current  Report on Form 8-K dated  September
13, 1994 of the Company and incorporated herein by reference.

     (9) Filed as an Exhibit to the Current  Report on Form 8-K dated August 26,
1994 of the Company and incorporated herein by reference.

     (10) Filed as an Exhibit to the Current  Report on Form 8-K dated  December
30, 1994 of the Company and incorporated herein by reference.

     (11) Filed as an Exhibit to the Annual  Report on Form 10-K of the  Company
for the year ended December 31, 1994.

     (12) Filed as an Exhibit to the Current  Report on Form 8-K dated  November
10, 1995 of the Company and incorporated herein by reference.

     

                                       20

<PAGE>
     (13) Filed as an Exhibit to the Annual  Report on Form 10-K of the  Company
for the year ended December 31, 1995.

     (14) Filed as an Exhibit to the Current  Report on Form 8-K dated April 26,
1996 of the Company and incorporated herein by reference.

     (15) Filed herewith.

                                       21

<PAGE>



                                                    SIGNATURES

     Pursuant  to the  requirements  of  Section  13 or 15(d) 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.

                                            PRIME MEDICAL SERVICES, INC.



                                            By /s/ Joseph Jenkins, M.D., J.D.
                                               ------------------------------  
                                               Joseph Jenkins, M.D., J.D., 
                                               President, Chief Executive 
                                               Officer and Director

                                            Date:  March 27, 1997

     Pursuant to the  requirements of the Securities  Exchange Act of 1934, this
report has been signed by the following  persons on behalf of the registrant and
in the capacities and on the dates indicated.



By: /s/ Kenneth S. Shifrin
    ---------------------- 
    Kenneth S. Shifrin
    Chairman of the Board

Date:  March 27, 1997


By: /s/ Cheryl L. Williams
    ----------------------
    Cheryl L. Williams
    Vice President of Finance, Secretary
    and Chief Financial Officer (Principal
    Financial and Accounting Officer)

Date:  March 27, 1997


By: /s/ Joseph Jenkins
    ------------------
    Joseph Jenkins, M.D., President,
    Chief Executive Officer and Director

Date:  March 27, 1997






                                       22

<PAGE>




By: /s/ Paul R. Butrus
    ------------------
     Paul R. Butrus, Director

Date:  March 27, 1997



By: /s/ William E. Foree
    --------------------
    William E. Foree, M.D., Director

Date:  March 27, 1997


By: /s/ Irwin Katz
    --------------
    Irwin Katz, Director

Date:  March 27, 1997


By: /s/ John McEntire
    -----------------
     John McEntire, Director

Date:   March 27, 1997


By: /s/ William A. Searles
    ----------------------
    William A. Searles, Director

Date:  March 27, 1997


By: /s/ Michael Spalding
    --------------------
    Michael Spalding, M.D., Director

Date:  March 27, 1997





                                       23


<PAGE>






                                   APPENDIX A

                                      INDEX
                                      -----
                                                                    Page
                                                                   ------

Independent Auditors' Report                                         A-2

Consolidated Financial Statements:

    Consolidated Statements of Income for the                        A-3
    years ended December 31, 1996, 1995 and 1994.           
         
    Consolidated Balance Sheets at December 31, 1996 and 1995.       A-4

    Consolidated Statements of Stockholders' Equity                  A-6
    for the years ended December 31, 1996, 1995 and 1994.              
         
    Consolidated Statements of Cash Flows for the years ended        A-7
    December 31, 1996, 1995 and 1994.
    
    Notes to Consolidated Financial Statements.                      A-12



Schedules:


   II - Valuation and Qualifying Accounts as of                      S-1
         December 31, 1996, 1995 and 1994.                                    
                  


                              --------------------



                                       A-1

<PAGE>



                          Independent Auditors' Report
                          ----------------------------



The Board of Directors and Shareholders
Prime Medical Services, Inc.:

We have audited the  accompanying  consolidated  financial  statements  of Prime
Medical   Services,   Inc.  and  subsidiaries   ("Company")  as  listed  in  the
accompanying index. In connection with our audits of the consolidated  financial
statements,  we also have audited the financial  statement schedule as listed in
the accompanying  index. These consolidated  financial  statements and financial
statement  schedule are the  responsibility  of the  Company's  management.  Our
responsibility  is  to  express  an  opinion  on  these  consolidated  financial
statements and financial statement schedule based on our audits.

We  conducted  our  audits  in  accordance  with  generally   accepted  auditing
standards.  Those standards require that we plan and perform the audit to obtain
reasonable assurance about whether the financial statements are free of material
misstatement.  An audit includes examining, on a test basis, evidence supporting
the amounts and disclosures in the financial statements.  An audit also includes
assessing the  accounting  principles  used and  significant  estimates  made by
management,  as well as evaluating the overall financial statement presentation.
We believe that our audits provide a reasonable basis for our opinion.

In our opinion, the consolidated  financial statements referred to above present
fairly,  in all  material  respects,  the  financial  position of Prime  Medical
Services,  Inc. and  subsidiaries at December 31, 1996 and 1995, and the results
of their operations and their cash flows for each of the years in the three-year
period ended December 31, 1996, in conformity with generally accepted accounting
principles.  Also in our opinion, the related financial statement schedule, when
considered in relation to the basic consolidated financial statements taken as a
whole,  presents  fairly,  in all material  respects,  the information set forth
therein.

/s/ KPMG Peat Marwick LLP
Austin, Texas
February 21, 1997











                                       A-2

<PAGE>



                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                        CONSOLIDATED STATEMENTS OF INCOME

($ in thousands, except per share data)
<TABLE>
<CAPTION>
                                                                                    Years Ended December 31,
                                                                     --------------------------------------------            
                                                                          1996             1995              1994
                                                                          ----             ----              ----
<S>                                                                  <C>                <C>               <C>
Fee Revenue:
   Lithotripsy:
         Fee revenues                                                $   65,138         $ 19,306          $ 14,721
         Management fees                                                  4,698            1,617                31
         Equity income                                                    1,766            1,230                91
                                                                    -----------      -----------       -----------
                                                                         71,602           22,153            14,843
   Imaging and Cardiac                                                      802            1,042             9,925
                                                                   ------------      -----------        ----------
                                                                         72,404           23,195            24,768
                                                                    -----------       ----------         ---------
Costs and expenses:
   Cost of services and general and
       administrative expenses
         Lithotripsy                                                     19,922            5,979             4,283
         Imaging and Cardiac                                                632            1,505             8,580
            Corporate                                                     4,245            2,573             2,414
                                                                     ----------       ----------        ----------
                                                                         24,799           10,057            15,277

    Depreciation and amortization                                         7,455            3,195             2,975
                                                                     ----------       ----------        ----------
                                                                         32,254           13,252            18,252
                                                                      ---------        ---------         ---------

Operating income                                                         40,150            9,943             6,516

Other income (deductions):
     Interest and dividends                                                 459              152               219
     Interest expense                                                    (5,977)         ( 1,231)            ( 902)
     Loan fees and stock offering costs                                  (3,535)             --                --
     Other, net                                                             370              647             (  91)
                                                                    -----------     ------------        ----------

                                                                         (8,683)         (   432)            ( 774)
                                                                    -----------      -----------         ---------

Income before provision for income taxes
     and minority interest                                               31,467            9,511             5,742

Minority interest in consolidated income                                 20,510            1,421               691

Provision for income taxes                                                1,996              886               547
                                                                    -----------      -----------        ----------

Net income                                                          $     8,961       $    7,204         $   4,504
                                                                    ===========       ==========         =========

Primary earnings per share:
     Net income                                                     $      0.48      $      0.47        $     0.31
                                                                    ===========      ===========        ==========

     Weighted average shares outstanding                                 18,606           15,298            14,509
                                                                     ==========       ==========         =========

Fully diluted earnings per share:
     Net income                                                     $      0.48      $      0.46        $     0.31
                                                                    ===========      ===========        ==========

     Weighted average shares outstanding                                 18,898           16,010            14,650
                                                                     ==========       ==========         =========
</TABLE>

          See accompanying notes to consolidated financial statements.
                                       A-3

                                                           

<PAGE>




                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                           CONSOLIDATED BALANCE SHEETS


($ in thousands)



                                                    December 31,
                                           -----------------------      
                                              1996         1995
                                           ----------   ----------

ASSETS

Current assets:
  Cash                                     $   20,096   $    4,692
   Accounts receivable, less allowance
    for doubtful accounts of $335 in
    1996 and $232 in 1995                      16,346        4,109
   Other receivables                            1,842          364
   Deferred income taxes                          948          770
   Prepaid expenses and other 
    current assets                                841        1,003
                                           ----------   ----------

     Total current assets                      40,073       10,938
                                           ----------   ----------

Property and equipment:
   Equipment, furniture and fixtures           22,339        7,867
   Leasehold improvements                         113          113
                                           ----------   ----------

                                               22,452        7,980

Less accumulated depreciation and
   amortization                                (7,122)      (3,272)
                                           ----------   ----------

     Property and equipment, net               15,330        4,708
                                           ----------   ----------


Investment in American Physicians
  Service Group, Inc.                             173          173
Other investments                               7,927        7,623
Goodwill, at cost, net of amortization        132,302       52,679
Other noncurrent assets                         1,948        1,506
                                           ----------   ----------

                                           $  197,753   $   77,627
                                           ==========   ==========









          See accompanying notes to consolidated financial statements.
                                       A-4

                                                           

<PAGE>



                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                     CONSOLIDATED BALANCE SHEETS (continued)


($ in thousands)


                                                 December 31,
                                           -----------------------
                                              1996         1995
                                           ----------   ----------
LIABILITIES:

Current Liabilities:

   Current portion of long-term debt       $   10,522   $    3,043
   Accounts payable                             4,451        4,814
   Accrued expenses                            16,582        2,862
                                           ----------   ----------

     Total current liabilities                 31,555       10,719

Long-term debt, net of current portion         70,910       22,323
Deferred income taxes                           5,423        1,212
                                           ----------   ----------

     Total liabilities                        107,888       34,254

Minority interest                              13,438          623

STOCKHOLDERS' EQUITY:

Preferred stock, $.01 par value,
  1,000,000 shares authorized;
  none outstanding                              --           --
Common stock, $.01 par value,
  40,000,000 shares authorized;
  19,078,933 issued in 1996 and
  14,729,663 issued in 1995                       191          147
Capital in excess of par value                 83,271       58,700
Accumulated deficit                            (7,035)     (15,996)
Treasury stock, at cost, 30,000 shares           --           (101)
                                           ----------   ----------

     Total stockholders' equity                76,427       42,750
                                           ----------   ----------

                                           $  197,753   $   77,627
                                           ==========   ==========












          See accompanying notes to consolidated financial statements.
                                       A-5

                                                           

<PAGE>



                          PRIME MEDICAL SERVICES, INC.
                 CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY
              For the years ended December 31, 1996, 1995 and 1994



($ in thousands, except share data)

<TABLE>
<CAPTION>

                                     Issued        Capital in   Accumulated
                                  Common Stock      Excess of    Earnings     Treasury Stock   Reciprocal
                                Shares    Amount    Par Value    (Deficit)   Shares    Amount  Stockholdings    Total
                             ---------- ----------  ----------  ----------- --------  -------- -------------  ---------
<S>                          <C>             <C>      <C>         <C>        <C>        <C>        <C>          <C>
Balance, January 1, 1994     14,458,663      $ 145    $ 58,590    ($27,704)     --        --        ($1,055)    $29,976

  Net income for the year          --          --          --        4,504      --        --             --       4,504
  Exercise of stock options     136,000          1          41         --       --        --             --          42
  Purchase of treasury stock       --          --          --          --    30,000     ( 101)           --        (101)
                             ----------  ---------  ----------  ---------- --------  --------- -------------  ----------
Balance, December 31, 1994   14,594,663        146      58,631     (23,200)  30,000     ( 101)     (  1,055)     34,421

  Net income for the year           --         --          --        7,204      --        --             --       7,204
  Exercise of stock options     135,000          1          69         --       --        --             --          70
  Reclassification of
    reciprocal stockholdings        --         --          --          --       --        --          1,055       1,055
                             ----------  ---------  ----------  ----------- -------  --------- -------------  ----------
Balance, December 31, 1995   14,729,663        147      58,700   (  15,996)  30,000     ( 101)           --      42,750

  Net income for the year           --         --          --        8,961      --        --             --       8,961
  Issuance of stock           1,636,364         17      14,903         --       --        --             --      14,920
  Exercise of stock options     477,666          5         488         --       --        --             --         493
  Debt converted to stock       921,415          9       5,241         --       --        --             --       5,250
  Exercise of warrants        1,343,825         13       4,040         --       --        --             --       4,053
  Retirement of treasury
      stock                  (   30,000)       --       (  101)        --   (30,000)      101            --         --
                             ----------  ---------  ----------- ----------- --------  -------- -------------  ---------
Balance, December 31, 1996   19,078,933     $  191   $  83,271   ($  7,035) $   --    $   --      $      --     $76,427
                             ==========  =========  =========== =========== ========  ======== =============  =========
</TABLE>


          See accompanying notes to consolidated financial statements.
                                       A-6

                                                         

<PAGE>




                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                      CONSOLIDATED STATEMENTS OF CASH FLOWS

($ in thousands)
<TABLE>
<CAPTION>
                                                                                          Years Ended December 31,
                                                                               -------------------------------------------- 
                                                                                    1996              1995             1994
                                                                                    ----              ----             ----
<S>                                                                            <C>                 <C>              <C>
CASH FLOWS FROM OPERATING ACTIVITIES:
  Fee and other revenue collected                                              $   72,452          $ 21,640         $ 25,017
  Cash paid to employees, suppliers
      of goods and others                                                         (25,190)          ( 9,094)         (14,268)
  Interest received                                                                   459               157              216
  Interest paid                                                                   ( 5,104)          ( 1,275)         (   785)
  Taxes paid                                                                      ( 1,015)          (   530)         (   662)
                                                                               ----------      ------------       ----------

           Net cash provided by operating activities                               41,602            10,898            9,518
                                                                               ----------       -----------        ---------

CASH FLOWS FROM INVESTING ACTIVITIES:
  Purchase of lithotripter entities                                               (66,742)          (15,033)         (14,837)
  Proceeds from sale of investment in American
                Physicians Service Group, Inc. stock                                  --              2,753              --
  Purchases of equipment and leasehold
       improvements                                                               ( 2,526)         (    473)        (    602)
  Deferred payments on lithotripter entities                                      ( 3,387)              --               --
  Sale of net assets of diagnostic centers                                            --                --             2,350
  Proceeds from sales of equipment                                                      6                21              120
  Investments                                                                       1,257               864              282
  Refund of deposit                                                                   --                --               176
  Other                                                                           (   378)         (      6)             153
                                                                                ---------        ----------       ----------

           Net cash (used by) investing activities                                (71,770)          (11,874)        ( 12,358)
                                                                                ---------        ----------       ----------

CASH FLOWS FROM FINANCING ACTIVITIES:
  Payments on notes payable & capital  leases,
       exclusive of interest                                                     ( 15,351)          ( 9,588)         ( 8,780)
  Borrowings on notes payable                                                      74,000            14,284           11,525
  Distributions to minority interest                                             ( 13,440)          ( 1,644)        (    440)
  Line of credit fees                                                                 --               (367)        (    866)
  Other                                                                               363                71         (     59)
                                                                                ---------        ----------        ----------

           Net cash provided by financing activities                               45,572             2,756            1,380
                                                                                ----------       -----------       ----------

NET INCREASE (DECREASE) IN CASH AND CASH
    EQUIVALENTS                                                                    15,404             1,780          ( 1,460)

Cash and cash equivalents, beginning of period                                      4,692             2,912            4,372
                                                                                ---------        ----------        ---------


Cash and cash equivalents, end of period                                       $   20,096        $    4,692        $   2,912
                                                                               ==========        ==========        =========
</TABLE>

          See accompanying notes to consolidated financial statements.
                                       A-7




                                                                  

<PAGE>




                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                CONSOLIDATED STATEMENTS OF CASH FLOWS (continued)

($ in thousands)
<TABLE>
<CAPTION>


                                                                                            Years Ended December 31,
                                                                                -------------------------------------------     
                                                                                    1996              1995             1994
                                                                                    ----              ----             ----
<S>                                                                             <C>                 <C>            <C>
Reconciliation of net income to net
 cash provided by operating activities
  Net income                                                                    $   8,961           $ 7,204        $   4,504
  Adjustments to reconcile net
    income to cash provided by
    operating activities:
       Depreciation and amortization                                                7,455             3,195            2,975
       Provision for uncollectible accounts                                           319               771            2,078
       Minority interest in consolidated income                                    20,510             1,421              691
       Equity in earnings of affiliates                                            (1,773)          ( 1,234)         (    86)
       Gain on sale of investment in American
              Physicians Service Group, Inc. stock                                    --            (   559)             --
       Provision for deferred income taxes                                            974               --               --
       Writeoff of loan fees                                                          696               --               --
       Other                                                                          --           (     33)              80
       Changes in operating  assets and  liabilities,  net of effect of purchase
         transactions:
           Accounts receivable                                                      1,284           (   541)         ( 1,035)
           Notes receivable                                                           180             1,416         (    206)
           Other receivables                                                          292               781              294
           Other current assets                                                       529           (   447)              62
           Accounts payable                                                           452            (1,224)           ( 177)
           Accrued expenses                                                         1,723               148              338
                                                                                 --------         ---------      -----------

        Total adjustments                                                          32,641             3,694            5,014
                                                                                 --------          --------       ----------

        Net cash provided by operating activities                                $ 41,602           $10,898        $   9,518
                                                                                 ========           =======        =========

</TABLE>













          See accompanying notes to consolidated financial statements.
                                       A-8

                                                                   

<PAGE>



                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                CONSOLIDATED STATEMENTS OF CASH FLOWS (continued)

($ in thousands)
<TABLE>
<CAPTION>


                                                                                         Years Ended December 31,
                                                                                -------------------------------------------
                                                                                    1996              1995             1994
                                                                                    ----              ----             ----
<S>                                                                               <C>               <C>              <C>   
SUPPLEMENTAL INFORMATION OF
  NON-CASH INVESTING AND
  FINANCING ACTIVITIES:

     In  1996,  the  Company  acquired  (1) 100% of the  outstanding  stock of a
corporation which operated 31 lithotripters  and (2) increased  ownership in two
partnerships,  in which the  Company  is the  managing  general  partner.  These
transactions  are  discussed   further  in  Note  D.  The  acquired  assets  and
liabilities were as follows:

           Current assets increased by                                            $ 19,032
           Noncurrent assets increased by                                           12,630
           Goodwill increased by                                                    82,297
           Current liabilities increased by                                         13,110
           Noncurrent liabilities increased by                                      69,712
           Minority interest increased by                                           16,218
           Stockholders' equity                                                     14,919

     In 1996,  several holders of notes issued by the Company elected to convert
the outstanding  balances of the notes into 921,000 shares of the Company stock.
In  addition,  certain  holders of warrants  exercised  their  warrants  and the
Company issued  1,344,000  shares of the Company's stock to the warrant holders.
The effect of these transactions were as follows:

           Current assets increased by                                               1,749
           Current liabilities decreased by                                          4,062
           Noncurrent liabilities decreased by                                       3,493
           Stockholders' equity increased by                                         9,304

     At December  31,  1996,  the Company had accrued  distributions  payable to
minority interests. The effect of this transaction was as follows:

           Current liabilities increased by                                         10,705
           Minority interest decreased by                                           10,705

</TABLE>



          See accompanying notes to consolidated financial statements.

                                       A-9

                                                                   

<PAGE>



                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                CONSOLIDATED STATEMENTS OF CASH FLOWS (continued)

($ in thousands)
<TABLE>
<CAPTION>

                                                                                            Years Ended December 31,
                                                                                --------------------------------------------
                                                                                    1996              1995             1994
                                                                                    ----              ----             ----

<S>                                                                               <C>              <C>                 <C>
     In  1995,  the  Company  acquired  (1) 100% of the  outstanding  stock of a
corporation  which owned or managed eight  lithotripter  operations  and (2) 70%
interest in a lithotripter  operation.  These transactions are discussed further
in Note D. The acquired assets and liabilities were as follows:

           Current assets decreased by                                                             $   9,905
           Noncurrent assets increased by                                                              2,491
           Goodwill increased by                                                                      19,553
           Current liabilities increased by                                                            7,249
           Noncurrent liabilities increased by                                                         4,890

     In 1995, the Company retired a note payable to American  Physicians Service
Group,  Inc. ("APS").  This note was retired by the Company  transferring to APS
shares of stock of APS that the Company owned. The effect of this transaction is
as follows:

           Current assets decreased by                                                                     3
           Investment in APS decreased by                                                                301
           Notes payable decreased by                                                                    297
           Loss                                                                                            7

     In 1994,  the Company  acquired (1) 100% of the  outstanding  stock of five
corporations, which own or manage lithotripter operations and (2) assets, net of
liabilities  assumed  of two  lithotripter  operations.  These  transaction  are
discussed in further detail in Note D. The acquired assets and liabilities  were
as follows:

           Current assets decreased by                                                                                 11,505
           Noncurrent assets increased by                                                                                 923
           Goodwill increased by                                                                                       20,257
           Current liabilities increased by                                                                             2,904
           Noncurrent liabilities increased by                                                                          6,771

</TABLE>

          See accompanying notes to consolidated financial statements.
                                      A-10

                                                               

<PAGE>



                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                CONSOLIDATED STATEMENTS OF CASH FLOWS (continued)

($ in thousands)
<TABLE>
<CAPTION>



                                                                                          Years Ended December 31,
                                                                                --------------------------------------------       
                                                                                    1996              1995             1994
                                                                                    ----              ----             ----

<S>                                                                               <C>              <C>                 <C>
     In 1994,  the Company sold its interests and  terminated  its management of
four imaging centers. These transactions are discussed in further detail in Note
E. The effect of these transactions is as follows:

           Current assets increased by                                                                                  3,302
           Noncurrent assets decreased by                                                                               3,368
           Goodwill decreased by                                                                                        2,193
           Current liabilities decreased by                                                                               851
           Noncurrent liabilities decreased by                                                                          1,408

</TABLE>






























          See accompanying notes to consolidated financial statements.

                                      A-11

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                  ---------------------------------------------
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS
                   ------------------------------------------


A.       ORGANIZATION AND OPERATION OF THE COMPANY
         -----------------------------------------

     Prime Medical  Services,  Inc.  ("Prime"),  through its direct and indirect
wholly-owned   subsidiaries,   provides   non-medical   management  services  to
lithotripsy   and  cardiac   rehabilitation   centers.   The  Company   operates
lithotripters  in 32 states.  In December  1994,  the Company sold its remaining
interest in the  diagnostic  imaging  centers that the Company owned or managed.
(See Note E).

B.       SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
         ------------------------------------------
         Consolidation
         -------------

     The consolidated  financial statements include the accounts of the Company,
its  wholly-owned  subsidiaries,  entities more than 50% owned and  partnerships
where the  Company has  control,  even  though its  ownership  is less than 50%.
Investments  in  entities  in which the  Company's  investment  is less than 50%
ownership,  and the Company does not control,  are  accounted  for by the equity
method if  ownership is between 20% - 50%, or by the cost method if ownership is
less than 20%. All significant  intercompany accounts and transactions have been
eliminated.

         Cash Equivalents
         ----------------

     The  Company  considers  as  cash  equivalents   demand  deposits  and  all
short-term investments with an original maturity of three months or less.

         Property and Equipment
         ----------------------

     Property  and  equipment  are  stated  at  cost.   Major   betterments  are
capitalized  while  normal  maintenance  and repairs are charged to  operations.
Depreciation  is computed by the  straight-line  method using  estimated  useful
lives of five to ten years.  Leasehold improvements are generally amortized over
ten years or the term of the lease,  whichever is shorter.  When assets are sold
or retired, the corresponding cost and accumulated  depreciation or amortization
are  removed  from the  related  accounts  and any gain or loss is  credited  or
charged to operations.

         Investments
         -----------

     Effective  January 1, 1996,  the  Company  acquired a 27%  general  partner
interest  in a  partnership  that  provides  lithotripsy  service in Ohio.  This
investment is accounted for using the equity method of accounting.






                                      A-12

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS


B.       SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, continued
         -----------------------------------------------------
         Investments, continued
         ----------------------

     In November 1996, the Company acquired a 4% interest in a partnership that
operates  two  mobile  lithotripters  in  North  Carolina.  This  investment  is
accounted for using the cost method of accounting.

     Effective June 1, 1995, the Company  acquired a 32.5% interest in a limited
liability company that operates a lithotripter facility in California. (See Note
D). This investment is accounted for using the equity method of accounting.

     The Company has  approximately a 1% ownership  interest in the company that
is its largest stockholder. Two of the Company's eight board members are also on
the board of its largest stockholder.  (See Note C). The Company's investment is
accounted for using the cost method of accounting in 1995 and 1996. In 1994, the
Company  accounted for its investment using the equity method when the Company's
ownership exceeded 20%.

     In  December  1994,  the  Company  acquired  100%  of the  stock  of  three
corporations,  which are the managing  general partners and owned an approximate
20% interest in each of three  partnerships  (See Note C). These investments are
accounted for using the equity method of accounting.

     The Company also has an ownership  interest of 50% in a joint  venture that
had owned a diagnostic  imaging center,  which was sold in August 1994 (See Note
E). This investment is accounted for using the equity method of accounting.

     Through December 31, 1996, the Company had recognized  $190,000 in earnings
using the equity  method.  This amount  represents  undistributed  earnings from
entities,  in which the  Company  owns 50 percent or less,  and does not exhibit
substantial control.

         Intangible Assets
         -----------------

     The Company  records as goodwill the excess of the purchase  price over the
fair value of the net assets of acquired businesses.  Goodwill is amortized over
a period not to exceed forty years using the  straight-line  basis.  Accumulated
amortization  at  December  31,  1996 and  1995 is  $5,798,000  and  $2,873,000,
respectively.  Goodwill is reviewed for impairment whenever events or changes in
circumstances  indicate that the carrying amount may not be recoverable.  If the
sum of the  expected  future  undiscounted  cash flows is less than the carrying
amount of the goodwill, a loss is recognized for the difference between the fair
value and carrying value of the goodwill.

                                      A-13

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

B.       SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, continued
         -----------------------------------------------------
         Revenue Recognition
         -------------------

     Revenues  generated  from  services are  recognized  as they are earned and
include,  under certain  contracts,  the reimbursement of contractually  defined
operating  expenses.  For the years ended December 31, 1996,  1995 and 1994, the
amounts included in revenues that were  reimbursement  of contractually  defined
operating expenses were $58,000, $82,000 and $3,483,000, respectively.

     The Company's  revenues are based upon  collectibility of fees for services
charged to hospitals, commercial insurance carriers and state and federal health
care agencies.

     At December 31, 1996,  approximately  17% of accounts  receivable relate to
units operating in Texas,  11% relate to units located in California,  9% relate
to units located in Florida and 9% relate to units located in South Carolina.

         Reciprocal Stockholdings
         ------------------------

     The Company had accounted for its  investment in its largest  shareholder's
common  stock on the  equity  basis  prior to 1995 (see Note C).  The  Company's
investment  was reduced for the  Company's pro rata interest in the common stock
of the Company  owned by such  shareholder.  This  reduction was reflected in an
offsetting  charge to reciprocal  stockholdings.  When the Company's  investment
dropped below 5%, reciprocal stockholdings were eliminated.

         Income Tax
         ----------
 
     Deferred  tax  assets and  liabilities  are  recognized  for the future tax
consequences   attributable  to  differences  between  the  financial  statement
carrying  amounts of existing assets and  liabilities  and their  respective tax
bases and operating loss and tax credit  carryforwards.  Deferred tax assets and
liabilities  are measured  using enacted tax rates  expected to apply to taxable
income in the years in which  those  temporary  differences  are  expected to be
recovered  or settled.  The effect on deferred tax assets and  liabilities  of a
change in tax rates is  recognized  in income in the period  that  includes  the
enactment date.







                                      A-14

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

B.       SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, continued
         ------------------------------------------------------
         Income Per Share
         ----------------

     Income  per  share is based on the  weighted  average  number  of shares of
common stock and common stock equivalent shares  outstanding during each period.
In 1995,  the Company  issued  convertible  debt,  in  conjunction  with certain
lithotripsy  acquisitions,  which  resulted in the  computation of fully diluted
earnings per share exceeding primary earnings per share by more than 3%.

         Long-Lived Assets
         -----------------

     Long-lived assets are reviewed for impairment whenever events or changes in
circumstances  indicate that the carrying amount may not be recoverable.  If the
sum of the  expected  future  undiscounted  cash flows is less than the carrying
amount of the asset, a loss is recognized,  if there is a difference between the
fair value and carrying value of the asset.

         Post Retirement/Post Employment Benefits
         ----------------------------------------

     The Company's  employee  benefits do not extend beyond an employee's active
employment.  Consequently,  no accrual  for future  benefits  as  prescribed  in
Statement  of  Financial  Accounting  Standards  No.  106 and No.  112 has  been
recorded.

         Derivative Financial Instruments
         --------------------------------

     The Company has not made use of derivative financial instruments as defined
in the Financial  Accounting  Standards Board Statement of Financial  Accounting
Standards No. 119,  Disclosure about Derivative  Financial  Instruments and Fair
Value of Financial Instruments.

         Notes Receivable
         ----------------

     Notes  receivable  are  recorded  at cost,  less  allowances  for  doubtful
accounts when deemed necessary.  The Financial Accounting Standards Board issued
Statement of Financial Accounting Standards No. 114, Accounting by Creditors for
Impairment of a Loan (Statement  114), in May 1993 and the related  Statement of
Financial Accounting Standards No. 118 Accounting by Creditors for Impairment of
a Loan - Income Recognition and Disclosures,  in October 1994 for implementation
in fiscal years  beginning  after  December 15,  1994.  Management,  considering
current  information and events  regarding the borrowers  ability to repay their
obligations,  considers  a note to be  impaired  when it is  probable  that  the
Company will be unable to collect all amounts due  according to the  contractual
terms of the note  agreement.  When a loan is  considered  to be  impaired,  the
amount of the  impairment  is measured  based on the  present  value of expected
future cash flows discounted at the note's effective interest rate.

                                      A-15

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS


     B.   SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES, continued
          -----------------------------------------------------      
          Notes Receivable, continued  
          ---------------------------  

     Impairment  losses are  included in the  allowance  for  doubtful  accounts
through a charge to bad debt expense. Cash receipts on impaired notes receivable
are applied to reduce the principal amount of such notes until the principal has
been recovered and are recognized as interest income,  thereafter.  The adoption
of  Statements  114 and 118 by the  Company  on  January  1, 1995 did not have a
material affect on the financial statements.

         Stock-Based Compensation
         ------------------------

     The  Financial  Accounting  Standards  Board issued  Statement of Financial
Accounting   Standards  No.  123,   Accounting  for   Stock-Based   Compensation
("Statement  123"), in October 1995 for implementation in fiscal years beginning
after  December 15, 1995.  Statement  123 became  effective  beginning  with the
Company's  first quarter of fiscal year 1996 and did not have a material  effect
on the Company's  financial position or results of operations.  Upon adoption of
Statement  123, the Company  continued to measure  compensation  expense for its
stock-based  employee  compensation  plans  using  the  intrinsic  value  method
prescribed by APB Opinion No. 25, Accounting for Stock Issued to Employees.  The
Company provides proforma disclosures of net income and earnings per share as if
the fair  value-based  method  prescribed  by Statement  123 had been applied in
measuring compensation expense. (See Note K).

         Estimates Used to Prepare Financial Statements
         ----------------------------------------------

     Management uses estimates and assumptions in preparing financial statements
in accordance with generally accepted accounting principles. Those estimates and
assumptions  affect  the  reported  amounts  of  assets  and  liabilities,   the
disclosure of contingent  assets and liabilities,  and the reported revenues and
expenses.  Actual  results  could vary from the  estimates  that were assumed in
preparing the financial statements.

         Reclassification
         ----------------

     Certain  reclassifications  have been made to amounts presented in previous
years to be consistent with the 1996 presentation.


                                      A-16

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS





C.       INVESTMENTS
         -----------
         Southern California
         -------------------

     Effective June 1, 1995, the Company  acquired a 32.5% interest in a limited
liability  company  that  operates a fixed site  lithotripter  near Los Angeles,
California.  The purchase price was cash of  $1,569,000.  This  transaction  was
accounted for using the purchase method of accounting.

         Texas, Ohio & Louisiana Partnerships
         ------------------------------------

     In December  1994,  the Company  acquired  all of the common stock of three
corporations.  Each  corporation is the general partner and holds an approximate
20%  interest in a limited  partnership  which  operates a mobile  lithotripter.
Texas ESWL/Laser  Lithotripter,  Ltd.  operates a mobile  lithotripter in Texas,
Oklahoma  and  Arkansas.  Ohio  Mobile  Lithotripter,  Ltd.  operates  a  mobile
lithotripter  in Ohio.  Arklatx  Mobile  Lithotripter,  L.P.  operates  a mobile
lithotripter in Louisiana.

     The  purchase  price paid by Prime for the common stock was  $5,007,000  in
cash. This transaction was accounted for using the purchase method of accounting
effective December 1, 1994.

     Condensed  unaudited  balance sheet for the three  partnerships at December
31:

                                              1996         1995
                                           ----------   ----------
Current assets                             $3,996,000   $4,327,000
Non-current assets                            451,000      729,000
                                           ----------   ----------

Total assets                               $4,447,000   $5,056,000
                                           ==========   ==========

Current liabilities                        $3,173,000   $3,770,000
Long-term liabilities                            --        311,000
Partners' capital                           1,274,000      975,000
                                           ----------   ----------

Total liabilities
and equity                                 $4,447,000   $5,056,000
                                           ==========   ==========






                                      A-17

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS





C.       INVESTMENTS, continued
         ----------------------
         Texas, Ohio & Louisiana Partnerships, continued
         -----------------------------------------------

     Condensed  unaudited  statement of earnings for the three  partnerships for
the year ended December 31:


                                              1996         1995
                                           ----------   ----------

Total revenues                             $9,985,000   $8,469,000
Total expenses                              2,926,000    3,519,000
                                           ----------   ----------

Net income                                 $7,059,000   $4,950,000
                                           ==========   ==========

     American Physicians Service Group, Inc.
     ---------------------------------------  

     At December 31, 1996 and 1995,  the Company  owned 50,000  shares of common
stock,  representing  approximately  1%,  of the  outstanding  common  stock  of
American  Physicians Service Group, Inc. (APS). APS owned  approximately 16% and
21%, respectively of the outstanding common stock of the Company at December 31,
1996 and 1995. The Company's pro rata interest in its own shares of common stock
had been included in stockholders'  equity as reciprocal  stockholdings prior to
1995. (See Note B).

     The Company occupies  approximately 2,800 square feet of office space owned
by APS. The Company also shares certain personnel with APS. The monthly rent and
personnel cost is approximately $4,000.

         Shasta Diagnostic Center Joint Venture
         --------------------------------------

     In 1989, the Company  acquired a 50% interest in Shasta  Diagnostic  Center
Joint Venture ("Shasta"),  a California general  partnership.  Shasta was formed
for the purpose of  operating  and  managing a  diagnostic  imaging  center.  In
September  1994,  the joint  venture sold the  operating  assets of the imaging
center.  The sales price was comprised of $450,000  cash, a promissory  note for
$450,000,  bearing interest at 8% and the assumption of approximately $2,145,000
in debt and lease obligations.

D.       ACQUISITIONS
         ------------

     Effective  May 1, 1996,  the Company  acquired  100% of the common stock of
Lithotripters,   Inc.  ("Litho").   Litho  operated  31  lithotripters   serving
approximately  200 locations in 19 states.  The purchase  price was  $86,500,000
consisting  of  $71,600,000  cash and 1,636,000  shares of the Company's  common
stock  valued at  $14,900,000.  This  transaction  was  accounted  for using the
purchase method of accounting.

                                      A-18

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS


D.       ACQUISITIONS, continued
         -----------------------

     Effective November 1, 1996, the Company increased its ownership interest in
two partnerships that operate lithotripters in Arkansas and South Carolina.  The
Company  acquired an additional  12.0%  interest in  Fayetteville  Lithotripters
Limited Partnership - Arkansas I and 2.7% interest in Fayetteville Lithotripters
Limited  Partnership - South  Carolina II, which the Company  manages as General
Partner.  The  purchase  price was  $1,291,000  in cash.  This  transaction  was
accounted for using the purchase method of accounting.

     Also effective  November 1, 1996, the Company  acquired a 4% ownership in a
partnership  that operates two  lithotripters  in North  Carolina.  The purchase
price was $550,000 in cash.  This  acquisition  was accounted for using the cost
method of accounting.

     Unaudited  proforma  combined  statement  of  earnings  for the year  ended
December  31,  1996 of the  Company and the  acquisitions  discussed  previously
assuming all were effective January 1, 1995 is as follows:

                                              1996         1995
                                           -----------  -----------

Total revenues                             $92,499,000  $82,934,000
Total expenses                              82,355,000   74,409,000
                                           -----------  -----------

Net earnings                               $10,144,000  $ 8,525,000
                                           ===========  ===========
Earnings per share                         $      0.53  $      0.49
                                           ===========  ===========

     Effective  October 1, 1995,  the Company  acquired 100% of the  outstanding
stock  of  Sun  Medical   Technologies,   Inc.   ("Sun").   Sun  operates  eight
lithotripters  servicing clients in California,  Arizona,  Montana,  New Mexico,
Washington and Wyoming. The purchase price was $16,150,000 consisting of cash of
$9,438,000,  deferred  payments  payable in January,  1996 of $2,687,000,  notes
payable of $4,025,000,  and warrants to purchase 200,000 shares of the Company's
common stock. The exercise price of the warrants represented the market price of
the  Company's  common  stock at the date the warrants  were  issued.  The notes
payable of  $4,025,000  may be converted  into 672,000  shares of the  Company's
common stock.  Each noteholder may convert all or part of the  outstanding  note
balance on the quarterly  payment dates.  (Note:  These  noteholders  elected to
convert the  outstanding  balances of their  notes into the  Company's  stock in
1996.)  This  acquisition  was  accounted  for  using  the  purchase  method  of
accounting.

     Effective June 1, 1995, the Company  acquired a 32.5% interest in a limited
liability  company  that  operates a fixed site  lithotripter  near Los Angeles,
California.  The purchase price was cash of  $1,569,000.  This  transaction  was
accounted for using the purchase method of accounting.



                                      A-19

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS


D.       ACQUISITIONS, continued
         -----------------------

     Effective July 1, 1995 the Company  acquired an undivided 70% interest in a
fixed site lithotripter located in Fort Lauderdale,  Florida. The purchase price
was $5,550,000 consisting of cash of $3,885,000 and notes payable of $1,665,000,
which can be converted  into 326,000 shares of the Company's  common stock.  The
noteholder  may  convert  all of the  balance  outstanding  on the  note  on the
quarterly  payment  dates.   (Note:  The  noteholder   elected  to  convert  the
outstanding  balance  of their  note  into the  Company's  stock in  1996.)  The
acquisition was accounted for using the purchase method of accounting.

     Unaudited  proforma  combined  statement  of  earnings  for the year  ended
December  31,  1995 of the  Company and the  acquisitions  discussed  previously
assuming all were effective January 1, 1994 is as follows:


                                              1995         1994
                                           -----------  -----------

Total revenues                             $31,771,000  $37,859,000
Total expenses                              23,851,000   31,665,000
                                           -----------  -----------

Net earnings                               $ 7,920,000  $ 6,194,000
                                           ===========  ===========
Earnings per share                         $      0.47  $      0.40
                                           ===========  ===========

     Effective  August 1,  1994,  the  Company  acquired  a mobile  lithotripter
operating in  Birmingham,  Alabama.  The purchase  price was cash of $2,863,000,
notes payable of  $2,620,000,  and a warrant to purchase  approximately  725,000
shares  of the  Company's  common  stock.  The  exercise  price  of the  warrant
represented  the  market  price of the  Company's  common  stock at the date the
warrant  was  issued.  (Note:  The  noteholder  exercised  its  warrants  and in
exchange,  considered the Company's $2,304,000 note paid in full, in 1996.) This
acquisition was accounted for using the purchase method of accounting.

     In July 1994, the Company acquired all of the outstanding stock of Alabama
Renal Stone  Institute,  Inc.  ("ARSI"),  which owns a  fixed-site  lithotripter
located  in  Birmingham,  Alabama  and had  previously  licensed  the use of the
lithotripter  to a  wholly-owned  subsidiary of the Company.  As a result,  ARSI
operates the lithotripter as a wholly-owned  subsidiary of the Company,  free of
certain  options that ARSI and its former  owners had to terminate  the license.
The purchase price was $3,895,000, and has been accounted for using the purchase
method of accounting.





                                      A-20

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS


D.       ACQUISITIONS, continued
         -----------------------

     In April  1994, the Company  acquired an undivided 60% interest in certain
assets,  subject to 60% of certain  liabilities  of Metro Atlanta  Stonebusters,
Inc.  ("MASI"),  which operated a mobile  lithotripter in the Atlanta,  GA area.
Prime paid to MASI $2,040,000 in cash and a promissory note issued in the amount
of $3,700,000, bearing interest at 6%. Prime contributed its interest in the net
assets acquired to Metro Atlanta Stonebusters, G.P. ("MASBGP") in exchange for a
60%  general  partnership  interest  in  MASBGP,  and MASI  contributed  its 40%
interest to MASBGP for a 40% interest in MASBGP.  This transaction was accounted
for using the purchase method of accounting.

     In January 1994, the Company acquired all of the outstanding capital stock
of Fazio Consulting,  Inc. ("FCI"),  which operated two mobile  lithotripters in
seven  states.  The purchase  price was cash of $950,000,  the  repayment of two
promissory notes of FCI in the aggregate amount of $1,100,000 and an earnout for
the next five years based on 50% of the net income of FCI. At December 31, 1994,
the Company  calculated the earnout for the first year to be $559,000,  and that
amount has been  recorded as goodwill and was  accounted  for using the purchase
method of accounting.  At December 31, 1995, the Company reached an agreement to
settle  the  remaining  four  years of the  earnout,  along with a buyout of the
remaining  term of two tractor  leases.  The Company has  recorded  the $700,000
settlement  as follows:  $685,000  recorded  to goodwill  and $15,000 to acquire
title to one tractor.

     Unaudited  proforma  combined  statement  of  earnings  for the year  ended
December  31,  1994 of the  Company and the  acquisitions  discussed  previously
assuming all were effective January 1, 1993 is as follows:

                                               1994         1993
                                           -----------  -----------

Total revenues                             $27,721,000  $27,904,000
Total expenses                              22,044,000   23,714,000
                                           -----------  -----------
Net earnings                               $ 5,677,000  $ 4,190,000
                                           ===========  ===========
Earnings per share                         $      0.39  $      0.34
                                           ===========  ===========

E.       DISPOSITIONS
         ------------

     In December  1994,  the Company sold its interest in the Grove  Diagnostic
Imaging Center.  The Company received two promissory  notes totaling  $1,155,000
and the buyer assumed approximately $1,200,000 in contractual obligations.

     In December  1994, the Company received $260,000 in cash for its equipment
and termination of its management contract, related to an imaging center managed
by the Company.


                                      A-21

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS


E.       DISPOSITIONS, continued
         -----------------------

     In August 1994, Shasta Diagnostic Center J.V., in which the Company owns a
50% interest,  sold the operating assets of Shasta Diagnostic  Imaging Center, a
multi-modality imaging center. The sales price was comprised of $450,000 cash, a
promissory  note for  $450,000,  bearing  interest at 8%, and the  assumption of
approximately $2,145,000 in debt and lease obligations.

     In  August  1994,  the  Company  sold the  operating  assets  of the Tower
Diagnostic  Center, a multi-modality  imaging center located in Tampa,  Florida.
The sales  price  was  comprised  of  $2,350,000  cash,  a  promissory  note for
$500,000,  bearing  interest  at  7.25%  and  the  assumption  of  approximately
$4,100,000 in capital and operating lease obligations.

     Summarized  results of operations for the centers  disposed of in 1994 were
as follows:

     Fee revenues                                $     8,292,000
     Cost of services and
       general and administrative expenses             6,705,000
     Depreciation and amortization                       941,000
                                                 ---------------
                                                         646,000
     Interest income                                      21,000
     Interest expense                                   (188,000)
     Other, net                                            3,000
                                                 ---------------
     Net income                                  $       482,000
                                                 ===============

F.       FAIR VALUE OF FINANCIAL INSTRUMENTS
         -----------------------------------

     Statement of Financial  Accounting  Standards No. 107,  "Disclosures  About
Fair Value of Financial Instruments"  (Statement 107), requires that the Company
disclose estimated fair values for its financial  instruments as of December 31,
1996 and 1995:
($ Amounts in Thousands)
<TABLE>
<CAPTION>

                                            1996                           1995
                                  -------------------------     -------------------------
                                   Carrying        Fair           Carrying       Fair
                                    Amount         Value          Amount         Value
                                  ----------     ----------     ----------     ----------
<S>                               <C>            <C>            <C>            <C>
Financial assets:
Cash                              $   20,096     $   20,096     $    4,692     $    4,692
Notes receivable                        --             --              203            200
Accounts receivable                   16,346         16,346          4,109          4,109
Other receivables                      1,842          1,842            183            183
Investment in American
Physicians Service Group, Inc.           173            325            173            481

</TABLE>

                                      A-22

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

F.         FAIR VALUE OF FINANCIAL INSTRUMENTS, continued
           ----------------------------------------------
<TABLE>
<CAPTION>

($ Amounts in Thousands)                  1996                             1995
                                  -------------------------     -------------------------
                                   Carrying        Fair           Carrying       Fair
                                    Amount         Value          Amount         Value
                                  ----------     ----------     ----------     ----------
<S>                               <C>            <C>            <C>            <C>
Financial liabilities:
Debt                                  81,432         81,432         25,366         25,281
Accounts payable                       4,451          4,451          4,814          4,814
</TABLE>

     Fair value estimates,  methods, and assumptions are set forth below for the
Company's financial instruments.

           Cash
           -----

     The carrying amounts for cash approximate fair value because they mature in
less than 90 days and do not present unanticipated credit concerns.

           Notes Receivable
           ----------------

     The fair value of notes has been  determined  using  discounted  cash flows
based on  management's  estimate of current  interest rates for notes of similar
credit quality.

           Accounts Receivable and Other Receivables
           -----------------------------------------

     The carrying value of these receivables  approximates the fair value due to
their short-term nature and historical collectibility.

           Investment in American Physicians Service Group, Inc.
           -----------------------------------------------------

     The fair value of the stock is based on the last trade  value at the end of
the year.

           Debt
           ----

     The carrying  value of debt  approximates  fair value since the majority is
primarily floating rate debt based on current market rates.

           Accounts Payable
           ----------------

     The  carrying  value of the  payables  approximates  fair  value due to the
short-term nature of the obligation.





                                      A-23

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

F.         FAIR VALUE OF FINANCIAL INSTRUMENTS, continued
           ----------------------------------------------
           Limitations
           -----------

     Fair  value  estimates  are made at a  specific  point  in  time,  based on
relevant market information and information about the financial instrument. Fair
value  estimates  are  based on  existing  on-and-off  balance  sheet  financial
instruments  without  attempting  to estimate  the value of  anticipated  future
business  and the  value of  assets  and  liabilities  that  are not  considered
financial  instruments.  Other  significant  assets and liabilities that are not
considered  financial assets or liabilities  include the deferred tax assets and
liabilities,   property  and  equipment,   equity  investment  in  partnerships,
goodwill,  other noncurrent  assets and accrued expenses.  In addition,  the tax
ramifications  related to the realization of the unrealized gains and losses can
have a significant  effect on fair value  estimates and have not been considered
in the aforementioned estimates.

G.       ACCRUED EXPENSES
         ----------------

         Accrued expenses consist of the following:


                                          December 31,      December 31,
                                              1996              1995
                                          ------------      ------------
Legal fees                                $   452,000       $   228,000
Accrued group insurance costs                 164,000           114,000
Compensation and payroll
related expense                             1,502,000         1,114,000
Taxes, other than income taxes                334,000            92,000
Accrued interest                            1,028,000           155,000
Provision for closed centers                  163,000           221,000
Income taxes payable                          761,000           384,000
Dividends payable to minority interest     10,705,000           183,000
Other                                       1,473,000           371,000
                                           ----------        ----------

                                          $16,582,000       $ 2,862,000
                                          ===========       ===========

                                      A-24

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

H.       INDEBTEDNESS
         ------------

     Outstanding  long-term  debts,  other  than  bank  debts,  are as  follows:

     Interest                                            December 31,
       Rates              Maturities                  1996           1995 
- --------------------    ---------------          ------------   ------------

None                    1997 - 2006              $    241,000   $    320,000
6% Note                    1997                       984,000      1,967,000
10% Note                    --                           --        1,561,000
11.25% -11.6%           1997 - 1998                    12,000        190,000
60 Day Libor +
  2 1/2%                    --                           --        3,690,000
Prime                       --                           --        2,304,000
                                                 ------------   ------------
                                                    1,237,000     10,032,000
Less current portion of
long-term debt                                      1,100,000      2,759,000
                                                 ------------   ------------

                                                 $    137,000   $  7,273,000
                                                 ============   ============

     $171,000 of the  non-interest  bearing notes are unsecured.  A non-interest
bearing note in the amount of $70,000 is secured by a mobile  lithotripter.  The
6% note, in the principal amount of $984,000 and $1,967,000 at December 31, 1996
and 1995,  respectively,  is secured by a Security Agreement which conveys first
security  title to the  assets  the  lender  sold to the  Company as part of the
acquisition by the Company of 60% of certain  assets,  subject to 60% of certain
liabilities  of Metro Atlanta  Stonebusters,  Inc. The 11.25% to 11.6% notes are
secured by medical and computer equipment.

     Outstanding long-term notes payable - banks are as follows:

   Interest                                               December 31,
    Rates                 Maturities                 1996           1995
- --------------------    ---------------          ------------   ------------

60-day LIBOR
  plus 2 1/2%             1997-2001              $ 76,750,000   $ 15,050,000
Prime                     1997-1998                 3,245,000           --
Prime + 1 1/2%              1997                      200,000        284,000
                                                 ------------   ------------
                                                   80,195,000     15,334,000
Less current portion of
long-term bank debt                                 9,422,000        284,000
                                                 ------------   ------------
                                                 $ 70,773,000   $ 15,050,000
                                                 ============   ============

                                      A-25

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS


H.     INDEBTEDNESS, continued
       -----------------------

     In  conjunction  with the  acquisition  discussion  in Note D, the  Company
increased  its bank  facility  with the Bank of Boston  from $25  million to $90
million.  The $50 million  term loan bears an interest  rate of LIBOR + 2 to 3%,
payable monthly and requires quarterly  principal payments beginning July, 1996,
with the final payment in April,  2001.  The $40 million line of credit bears an
interest rate of LIBOR + 2 to 3%,  payable  monthly and matures in April,  2001.
The facility is collateralized by the assets of the Company, including the stock
of its subsidiaries.

     The stated  principal  repayments for all  indebtedness  as of December 31,
1996 are payable as follows:

               1997                               $10,522,000
               1998                                10,134,000
               1999                                11,979,000
               2000                                12,696,000
               2001                                36,000,000
               Thereafter                             101,000


I.       COSTS OF SERVICES AND GENERAL AND ADMINISTRATIVE EXPENSES
         ---------------------------------------------------------

     Costs of services and general and  administrative  expenses  consist of the
following:


                                         Year Ended   Year Ended   Year Ended
                                           Dec. 31,    Dec. 31,     Dec. 31, 
                                             1996        1995         1994
                                         ----------   ----------   ----------

Salaries, wages and benefits             $11,953,000  $ 4,027,000  $ 5,460,000
Other costs of services                    6,878,000    3,412,000    6,014,000
Provision for bad debts                      150,000      573,000      805,000
General and administrative                 1,941,000      718,000    1,454,000
Legal and professional                     1,315,000      659,000      677,000
Other                                      2,562,000      668,000      867,000
                                         -----------  -----------  -----------
                                         $24,799,000  $10,057,000  $15,277,000
                                         ===========  ===========  ===========







                                      A-26

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

J.       COMMITMENTS AND CONTINGENCIES
         -----------------------------

     At  December  31,   1996,   minimum   annual   rental   commitments   under
non-cancelable  operating  leases  for  equipment  and office  space,  which may
contain renewal and escalation clauses, are:

                    1997              $ 313,000
                    1998                191,000
                    1999                188,000
                    2000                157,000
                    2001                  2,000
                    Thereafter              --

     Rent expense for  equipment  and office space for the years ended  December
31, 1996 was $360,000,  December 31, 1995 was $239,000 and December 31, 1994 was
$544,000.

     The Company sponsors two partially,  self-insured  group medical  insurance
plans.  One plan is  designed  to provide a specified  level of  coverage,  with
stop-loss coverage provided by a commercial insurer. The Company's maximum claim
exposure is limited to $35,000 per person per policy year. At December 31, 1996,
the  Company  had  48  employees   enrolled  in  the  plan.  The  plan  provides
non-contributory   coverage  for   employees  and   contributory   coverage  for
dependents.  The  second  plan is  designed  to  provide  a  specified  level of
coverage,  with stop-loss coverage provided by a commercial insurer. At December
31, 1996, the Company had 150 employees  enrolled in the plan. The plan provides
non-contributory   coverage  for   employees  and   contributory   coverage  for
dependents.  The  Company's  maximum  claim  exposure  is limited to $20,000 per
person per policy year. The Company's  contributions  totaled  $224,000 in 1996,
$150,000 in 1995, and $431,000 in 1994.


K.         COMMON STOCK OPTIONS
           --------------------
           1993 Stock Option Plan:
           -----------------------

     The Company has elected to follow  Accounting  Principles Board Opinion No.
25,   "Accounting  for  Stock  Issued  to  Employees"  ("APB  25")  and  related
Interpretations  in  accounting  for its  employee  stock  options  because,  as
discussed below,  the alternative fair value accounting  provided for under FASB
Statement No. 123,  "Accounting for Stock-Based  Compensation,"  requires use of
option  valuation  models that were not  developed  for use in valuing  employee
stock  options.  Under  APB 25,  because  the  exercise  price of the  Company's
employee stock options  equals the market price of the  underlying  stock on the
date of grant, no compensation expense is recognized.




                                      A-27

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

K.         COMMON STOCK OPTIONS, continued
           --------------------------------
          
     On October 12, 1993,  the Company  adopted the 1993 Stock Option Plan which
authorizes  the  grant of up to  2,000,000  shares  to  certain  key  employees,
directors,  and consultants  and advisors to the Company.  Options granted under
the 1993 Stock  Option  Plan shall  terminate  after ten years from the date the
option is granted,  unless the option terminates sooner by reason of termination
of employment, disability or death.

     A summary of the Company's stock option activity,  and related  information
for the years ended December 31, follows:
<TABLE>
<CAPTION>

                                            1996                             1995                             1994
                                ------------------------------   -------------------------------   -------------------------------
                                   Options   Weighted-Average       Options     Weighted-Average     Options      Weighted-Average
                                    (000)     Exercise Price         (000)       Exercise Price       (000)        Exercise Price
                                -----------  -----------------    -----------   ----------------   ------------   ----------------
<S>                             <C>          <C>                  <C>           <C>                <C>            <C> 
Outstanding - beginning of year        975   $           1.31         1,055     $           0.98       1,156      $           0.85
Granted                                730              13.87            55                 5.58          65                  3.05
Exercised                             (477)              0.52          (135)                0.52        (136)                 0.31
Forfeited                             ( --)                --          ( --)                  --        ( 30)                 3.46
                                -----------  -----------------    -----------   ----------------   ------------   ----------------
Outstanding-end of year               1,228   $          8.99           975     $           1.31       1,055      $           0.98
                                ===========   ================    ===========   ================   ============   ================

Exercisable at end of year              422   $          2.03           816     $           0.75         813      $           0.55

Weighted-average fair
  value of options granted
  during the year              $       6.13                --     $    2.07                   --         N/A                    --

</TABLE>









                                      A-28

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

K.         COMMON STOCK OPTIONS, continued
           -------------------------------

     The  following  table  summarizes  the  Company's  outstanding  options  at
December 31, 1996:
<TABLE>
<CAPTION>

                                                                        Average        Weighted
                                                                       Remaining        Average
                                                                      Contractual      Exercise
           Range of Exercise Prices                      Shares           Life           Price
           ------------------------                    ---------      -----------      ---------
           <S>                                         <C>            <C>              <C>   
           $  0.25 - $  4.12                             447,000      2.2 years          $  1.39
           $  4.13 - $  8.25                              50,000      4.9 years          $  5.75
           $  8.26 - $12.37                               25,000      4.0 years          $  8.94
           $12.38 - $16.50                               706,000      4.7 years           $14.04
                                                       ---------

           Total                                       1,228,000
                                                       =========
</TABLE>
               
     Pro forma  information  regarding  net  income  and  earnings  per share is
required  by  Statement  123,  and has been  determined  as if the  Company  had
accounted  for its employee  stock  options  under the fair value method of that
Statement.  The fair value for these  options was estimated at the date of grant
using a  Black-Scholes  1995 and 1996 option  pricing  model with the  following
weighted-average assumptions for 1995 and 1996, respectively: risk-free interest
rates of 5.7% and 6.2%;  dividend yields of 0% and 0%; volatility factors of the
expected  market  price of the  Company's  common  stock  of .38 and .53;  and a
weighted-average expected life of the option of 4 years.

     The  Black-Scholes   option  valuation  model  was  developed  for  use  in
estimating the fair value of traded  options which have no vesting  restrictions
and are fully  transferable.  In addition,  option  valuation models require the
input of highly  subjective  assumptions  including  the  expected  stock  price
volatility.  Because the Company's  employee stock options have  characteristics
significantly different from those of traded options, and because changes in the
subjective input assumptions can materially  affect the fair value estimate,  in
management's  opinion, the existing models do not necessarily provide a reliable
single measure of the fair value of its employee stock options.








                                      A-29

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS


K.         COMMON STOCK OPTIONS, continued
           -------------------------------

     For  purposes of pro forma  disclosures,  the  estimated  fair value of the
options is amortized to expense over the options' vesting period.  The Company's
pro forma  information  follows  (in  thousands  except for  earnings  per share
information):

                                                      1996           1995
                                                   ----------      ---------

      Pro forma net income                         $ 8,109         $ 7,197
      Pro forma earnings
       per share
         Primary                                     $0.44           $0.47
         Fully Diluted                               $0.43           $0.46


L.       OTHER INCOME (EXPENSE)
         ----------------------

     Included in other, net in the consolidated statements of operations are the
following components:
                                              Years Ended December 31,
                                            1996         1995         1994
                                         ----------   ----------   ----------
Collections on amounts 
     previously written off              $  192,000         --           --
Gain on sale of investment 
     in American Physicians
     Service Group, Inc. stock                 --        559,000         --
Equipment rental                             58,000         --           --
Equity in income of affiliates                 --           --          9,000
Loss on sale of
marketable securities                          --           --        (43,000)
Other income (expense)                      120,000       88,000      (57,000)
                                         ----------   ----------   ----------
Other, net                               $  370,000   $  647,000   $  (91,000)
                                         ==========   ==========   ==========

M.       INCOME TAXES
         ------------

     The Company  recognized  $97,000,  $110,000 and $114,000 in current Federal
income tax expense for 1996, 1995 and 1994 respectively,  consisting entirely of
alternative minimum tax.




                                      A-30

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

M.       INCOME TAXES, continued
         -----------------------

     The tax  effects of  temporary  differences  that give rise to  significant
portions of the deferred tax assets and deferred tax liabilities at December 31,
1996 and 1995 are presented below.

                                                                              
                                                     1996            1995
                                                 -----------    ------------
         Deferred tax assets:
           Accounts receivable,
             principally due to allowance
             for doubtful accounts               $   114,000    $     79,000
           AMT credit carryforwards                  249,000         374,000
           Net operating loss carryforwards          944,000       4,088,000
           Investment tax credit carryforwards     1,200,000       1,200,000
           Accrued expenses deductible
             for tax purposes when paid              834,000         573,000
           Other                                     829,000         162,000
                                                 -----------    ------------
             Total gross deferred tax
              assets                               4,170,000       6,476,000
             Less valuation allowance             (2,399,000)     (5,492,000)
                                                 -----------    ------------
             Net deferred tax assets               1,771,000         984,000
                                                 -----------    ------------

         Deferred tax liabilities:
           Property and equipment,
             principally due to
             differences in depreciation           ( 516,000)       (334,000)
           Investments in affiliated
             entities, principally due to
             undistributed income                 (2,860,000)     (  430,000)
           Intangible assets, principally
             due to differences in
             amortization periods for tax
             purposes                             (1,872,000)     (  460,000)
           IRS Section 481(A) adjustment
             for partnerships acquired            (  175,000)            --
                                                 -----------      ----------
           Total gross deferred tax
               liabilities                        (5,423,000)     (1,224,000)
                                                 -----------      ----------
           Net deferred tax liability            ($3,652,000)     ($ 240,000)
                                                 ===========      ==========


                                      A-31

<PAGE>


                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                   NOTES TO CONSOLIDATED FINANCIAL STATEMENTS





M.       INCOME TAXES, continued
         -----------------------

     The valuation allowance for deferred tax assets as of December 31, 1996 was
$2,399,000  representing a decrease of $3,093,000,  primarily due to utilization
of net operating loss  carryforwards.  The valuation  allowance for deferred tax
assets  as of  January  1,  1995 was  $7,583,000  with the  change  in the total
valuation  allowance  for the year ended  December  31, 1995 being a decrease of
$2,091,000.  The Company  believes that the valuation  allowance at December 31,
1996 is necessary  due to  uncertainties  regarding the Company's use of the net
operating loss  carryforwards  and tax credit  carryforwards  which could become
limited  in the event  that the  Company  experiences  a greater  than 50% stock
ownership  change in a  three-year  period (as defined in the  Internal  Revenue
Service regulations).

     At December 31, 1996, net operating loss carryforwards  available to reduce
future taxable income  amounted to  approximately  $2,777,000 and expire through
2008. Investment tax credit  carryforwards,  which expire through 2000, amounted
to $1,200,000 at December 31, 1996.

     Based  upon the level of  historical  taxable  income and  projections  for
future  taxable  income  over the  periods  which the  deferred  tax  assets are
deductible,  management  believes it is more  likely  than not the Company  will
realize  the  benefits  of these  deductible  differences,  net of the  existing
valuation  allowances at December 31, 1996. The amount of the deferred tax asset
considered  realizable,  however, could be reduced in the near term if estimates
of future taxable income during the carryforward period are reduced.

N.       RELATED PARTY TRANSACTIONS
         --------------------------

     See  Notes B and C for  additional  related  party  transactions  involving
investments in affiliates.

     O.  SUBSEQUENT EVENT  
         ---------------- 

     In January 1997 the Company purchased  additional ownership interests in 10
partnerships,  which the Company  controls.  The purchase  price for  additional
ownership  interests was $10,510,000 in cash. These  transactions were accounted
for using the purchase method of accounting.

                                      A-32

<PAGE>


                                                            SCHEDULE II
                                                            -----------

                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                        VALUATION AND QUALIFYING ACCOUNTS

($ in thousands)
<TABLE>
<CAPTION>


                                                           Additions
                                                           ---------- 
                                                           Charged to                         Balance at
                                       Beginning of         Costs and                           End of
      Description                          Period            Accounts         Deductions        Period
      -----------                      ------------        ----------        -----------      ---------- 
<S>                                    <C>                 <C>               <C>              <C>
Year ended December 31, 1996:

  Accounts Receivable
    Allowance for doubtful
     accounts                          $        232        $      319        $      216 (A)   $     335
                                       =============       ===========       ===========      ==========

Year ended December 31, 1995:

  Accounts Receivable
    Allowance for doubtful
    accounts                           $        938        $      531        $   1,237 (A)    $     232
                                       =============       ===========       ==========       ==========


Year ended December 31, 1994:

  Accounts Receivable
    Allowance for doubtful
    accounts                           $     1,625         $   1,857         $   2,544 (A)    $     938
                                       ============        ==========        ==========       ==========


</TABLE>






- -------------------------------


     (A)  Accounts  receivable  written off against the  allowance  for doubtful
accounts and other minor reclassifications.






                                       S-1


                                                                  
<PAGE>




                                                                   EXHIBIT 10.22
                          PRIME MEDICAL SERVICES, INC.

                              AMENDED AND RESTATED
                                 LOAN AGREEMENT

                                 $50,000,000.00

                                    TERM LOAN

                                       and

                                 $40,000,000.00

                              REVOLVING CREDIT LOAN

                       THE FIRST NATIONAL BANK OF BOSTON,
                  as Administrative Agent and Syndication Agent

                           NATIONSBANK OF TEXAS, N.A.,
                             as Documentation Agent

                                       and

                             THE BANKS NAMED HEREIN,
                                    as Banks

                           Dated as of April 26, 1996




                                      A-36

<PAGE>




                                TABLE OF CONTENTS

                                      Page


ARTICLE I DEFINITIONS............................................1

 Section 1.1 Amendment and Restatement...........................1
 Section 1.2 Definitions.........................................1
 Section 1.3 Other Definitional Provisions......................14

ARTICLE II ADVANCES.............................................14

 Section 2.1 Commitments........................................14
 Section 2.2 Notes..............................................15
 Section 2.3 Repayment of Advances..............................15
 Section 2.4 Interest...........................................15
 Section 2.5 Borrowing Procedure................................16
 Section 2.6 Continuations; Conversions.........................16
 Section 2.7 Use of Proceeds....................................17
 Section 2.8 Fees...............................................17

ARTICLE III PAYMENTS............................................17

 Section 3.1 Method of Payment..................................17
 Section 3.2 Optional Prepayment................................18
 Section 3.3 Mandatory Prepayments..............................18
 Section 3.4 Pro Rata Treatment.................................19
 Section 3.5 Non-Receipt of Funds by the Administrative Agent...19
 Section 3.6 Withholding Taxes..................................19
 Section 3.7 Withholding Tax Exemption..........................20
 Section 3.8 Computation of Interest............................20
 Section 3.9 Order of Application...............................20

ARTICLE IV YIELD PROTECTION AND ILLEGALITY......................21

 Section 4.1 Additional Costs...................................21
 Section 4.2 Limitation on Eurodollar Advances..................22
 Section 4.3 Illegality.........................................22
 Section 4.4 Treatment of Eurodollar Advances...................22
 Section 4.5 Compensation.......................................23
 Section 4.6 Capital Adequacy...................................23

ARTICLE V SECURITY..............................................24
 Section 5.1 Collateral.........................................24
 Section 5.2 Setoff.............................................24
 Section 5.3 Guaranties.........................................24


                                       A-i

<PAGE>




ARTICLE VI CONDITIONS PRECEDENT.................................24

 Section 6.1 Initial Advance....................................24
 Section 6.2 All Advances.......................................26


ARTICLE VII REPRESENTATIONS AND WARRANTIES......................26

 Section 7.1 Existence..........................................27
 Section 7.2 Financial Statements...............................27
 Section 7.3 Corporate Action: No Breach........................27
 Section 7.4 Operation of Business..............................27
 Section 7.5 Litigation and Judgments...........................28
 Section 7.6 Rights in Properties; Liens........................28
 Section 7.7 Enforceability.....................................28
 Section 7.8 Approvals..........................................28
 Section 7.9 Debt...............................................28
 Section 7.10 Taxes.............................................28
 Section 7.11 Use of Proceeds; Margin Securities................28
 Section 7.12 ERISA.............................................28
 Section 7.13 Disclosure........................................29
 Section 7.14 Subsidiaries; Partnerships........................29
 Section 7.15 Agreements........................................29
 Section 7.16 Compliance with Legal Requirements; 
              Governmental Authorizations.......................29
 Section 7.17 Investment Company Act............................30
 Section 7.18 Public Utility Holding Company Act................30
 Section 7.19 Environmental Matters.............................30
 Section 7.20 Acquisition.......................................30

ARTICLE VIII POSITIVE COVENANTS.................................31

 Section 8.1 Reporting Requirements.............................31
 Section 8.2 Maintenance of Existence; Conduct of Business......33
 Section 8.3 Maintenance of Properties..........................33
 Section 8.4 Taxes and Claims...................................33
 Section 8.5 Insurance..........................................33
 Section 8.6 Inspection Rights..................................34
 Section 8.7 Keeping Books and Records..........................34
 Section 8.8 Compliance with Laws...............................34
 Section 8.9 Compliance with Agreements.........................34
 Section 8.10 Further Assurances................................34
 Section 8.11 ERISA.............................................34
 Section 8.12 Information Relating to Proposed Acquisitions.....34
 Section 8.13 After-Acquired Subsidiaries.......................34
 Section 8.14 Syndication Cooperation...........................35

ARTICLE IX NEGATIVE COVENANTS...................................35

 Section 9.1 Debt...............................................35
 Section 9.2 Limitation on Liens................................35
 Section 9.3 Mergers, Etc.......................................36

                                      A-ii

<PAGE>




 Section 9.4 Restricted Payments................................36
 Section 9.5 Investments........................................36
 Section 9.6 Limitation on Issuance of Capital Stock............37
 Section 9.7 Transactions With Affiliates.......................37
 Section 9.8 Disposition of Assets..............................37
 Section 9.9 Sale and Leaseback.................................37
 Section 9.10 Prepayment of Debt................................37
 Section 9.11 Nature of Business................................37
 Section 9.12 Environmental Protection..........................38
 Section 9.13 Accounting........................................38
 Section 9.14 Amendment of Partnership and Management 
              Agreements........................................38

ARTICLE X FINANCIAL COVENANTS...................................38

 Section 10.1 Total Debt to EBITDA..............................38
 Section 10.2 Interest Coverage Ratio...........................38
 Section 10.3 Total Debt Service Coverage Ratio.................39
 Section 10.4 Consolidated Net Worth............................39
 Section 10.5 Minimum EBITDA....................................39

ARTICLE XI DEFAULT..............................................39

 Section 11.1 Events of Default.................................39
 Section 11.2 Remedies..........................................41
 Section 11.3 Performance by the Administrative Agent...........42

ARTICLE XII THE ADMINISTRATIVE AGENT............................42

 Section 12.1 Appointment, Powers and Immunities................42
 Section 12.2 Rights of Administrative Agent as a Bank..........43
 Section 12.3 Sharing of Payments, Etc..........................43
 Section 12.4 Indemnification...................................44
 Section 12.5 Independent Credit Decisions......................44
 Section 12.6 Several Commitments...............................45
 Section 12.7 Successor Administrative Agent....................45
 Section 12.8 Independent Contractor............................45

ARTICLE XIII MISCELLANEOUS......................................46

 Section 13.1 Expenses..........................................46
 Section 13.2 Indemnification...................................46
 Section 13.3 No Duty...........................................46
 Section 13.4 No Fiduciary Relationship.........................46
 Section 13.5 No Waiver; Cumulative Remedies....................47
 Section 13.6 Successors and Assigns............................47
 Section 13.7 Survival..........................................49
 Section 13.8 Entire Agreement..................................49
 Section 13.9 Amendments, Etc...................................49
 Section 13.10 Maximum Interest Rate............................50
 Section 13.11 Notices..........................................50
 Section 13.12 Governing Law....................................50

                                      A-iii

<PAGE>




 Section 13.13 Counterparts.....................................50
 Section 13.14 Severability.....................................50
 Section 13.15 Headings.........................................50
 Section 13.16 Construction.....................................50
 Section 13.17 Independence of Covenants........................50
 Section 13.18 Confidentiality..................................51
 Section 13.19 Renewal and Increase.............................51
 Section 13.20 Waiver of Jury Trial.............................51
 Section 13.21 Choice of Forum; Consent to Service of 
               Process and Jurisdiction.........................52


                                INDEX TO EXHIBITS

Exhibit   Description of Exhibit


A         Advance Request Form
B         Form of Assignment and Acceptance
C         Borrower Security Agreement
D         Form of Guaranty
E         Form of Guarantor Security Agreement
F         Form of Pledge Agreement
G         Form of Revolving Credit Note
H         Form of Term Note
I         Perfection Certificate
J         Form of Opinion of Counsel for Borrower and the Guarantors
K         Compliance Certificate


                               INDEX TO SCHEDULES

Schedule             Description of Schedule

1                    Commitments
2                    Guarantors
3                    Partnerships
7.5                  Existing Litigation
7.9                  Existing Debt
7.14.1               Capitalization of Subsidiaries
7.14.2               Partners
7.15                 Agreements
7.16                 Governmental Disclosures
7.19                 Environmental Matters
9.2                  Existing Liens



                                      A-iv

<PAGE>




                       AMENDED AND RESTATED LOAN AGREEMENT

     THIS AMENDED AND RESTATED LOAN  AGREEMENT  (the  "Agreement"),  dated as of
April 26, 1996, is among PRIME MEDICAL  SERVICES,  INC., a Delaware  corporation
("Borrower"),  each of the banks or other lending institutions which is or which
may from time to time become a  signatory  hereto or any  successor  or assignee
thereof  (collectively,  the  "Banks"  and  individually,  a "Bank"),  THE FIRST
NATIONAL  BANK  OF  BOSTON  ("FNBB"),   a  national  banking   association,   as
Administrative Agent for itself and the other Banks (in such capacity,  together
with its successors in such capacity, the "Administrative  Agent"),  NATIONSBANK
OF TEXAS, N.A. ("NationsBank"), a national banking association, as Documentation
Agent for  itself  and the  other  Banks (in such  capacity,  together  with its
successors  in  such  capacity,   the  "Documentation   Agent"),  and  FNBB,  as
Syndication  Agent  (in such  capacity,  together  with its  successors  in such
capacity, the "Syndication Agent").

                                 R E C I T A L S

     1.  Reference  is hereby made to that certain  Loan  Agreement  dated as of
November 28, 1994, by and between Borrower, the Banks defined therein, and FNBB,
as Agent  for the  Banks  defined  therein  as  amended  by that  certain  First
Amendment to Loan Agreement  dated as of August 17, 1995 (the  "Original  Credit
Agreement").

     2.  Borrower has  requested  that the Banks  increase the  Commitments  (as
defined in the  Original  Credit  Agreement),  provide to Borrower the Term Loan
Commitment (as defined herein), admit additional financial institutions as Banks
hereunder and modify certain other  provisions  contained in the Original Credit
Agreement.

     3. The  Administrative  Agent,  the  Documentation  Agent,  the Syndication
Agent,  the Banks and  Borrower  desire and have agreed to amend and restate the
Original Credit Agreement in its entirety as and pursuant to this Agreement.

     NOW THEREFORE,  in  consideration  of the premises and the mutual covenants
herein contained, the parties hereto agree as follows:

                                    ARTICLE I

                                   DEFINITIONS

     Section 1.1    Amendment  and  Restatement.  
                    ----------------------------

     This  Agreement  is  in  renewal,  extension,  modification,  increase  and
restatement of the Original Credit Agreement.

     Section 1.2    Definitions.  
                    ------------

     As used in this  Agreement,  the  following  terms shall have the following
meanings:

     "Acquisition" means any transaction, or any series of related transactions,
consummated  on or after the date hereof,  by which  Borrower or any  Subsidiary
directly or indirectly  (a) acquires all or  substantially  all of the assets of
any Person,  whether  through  purchase of assets,  merger,  or  otherwise,  (b)
acquires (in one  transaction  or as the most recent  transaction in a series of
transactions)  at least a majority  (in number of votes) of the  securities  (or
similar ownership  interests) of any Person, or (c) acquires (in one transaction
or as the most  recent  transaction  in a  series  of  transactions)  at least a
majority of the general partnership interests of any Person.

     "Additional Costs" has the meaning specified in Section 4.1.

     "Adjusted  Eurodollar  Rate"  means,  for any  Eurodollar  Advance  for any
Interest Period therefor, the rate per annum (rounded upwards, if necessary,  to
the nearest 0.01%) determined by the Administrative Agent to be equal to (a) the
Eurodollar Rate for such Eurodollar  Advance for such Interest Period divided by
(b) 1.00 minus the  Reserve  Requirement  for such  Eurodollar  Advance for such
Interest Period.


                                                                 
                                        1

<PAGE>




     "Administrative Agent" has the meaning specified in the preamble.

     "Advance" means (a) with respect to the Revolving Credit  Commitment,  each
advance of funds by the Banks,  or any of them, to Borrower  pursuant to Section
2.5(b),  and (b) with respect to the Term Loan  Commitment,  each advance by the
Banks to Borrower pursuant to Section 2.5(a).

     "Advance Request Form" means a certificate,  in  substantially  the form of
Exhibit A, properly completed and signed by Borrower requesting an Advance.

     "Affiliate"  means, as to any Person, any other Person (a) that directly or
indirectly, through one or more intermediaries, Controls or is Controlled by, or
is under common  Control  with,  such Person,  (b) that  directly or  indirectly
beneficially  owns or holds  five  percent  (5%) or more of any  class of voting
stock of such  Person,  or (c) five  percent (5%) or more of the voting stock of
which is  directly  or  indirectly  beneficially  owned or held by the Person in
question;  provided, however, in no event shall the Agents or any Bank be deemed
an Affiliate of Borrower or any of its Subsidiaries.

     "After-Acquired Subsidiary" has the meaning specified in Section 8.13.

     "Agents" means the  Administrative  Agent, the Documentation  Agent and the
Syndication Agent. "Agent" means any one of the Agents.

     "Alternate  Base Rate" means,  at any time, the greater of (a) the variable
rate of interest  established from time to time by the  Administrative  Agent as
its "base rate" and set by the Administrative  Agent as a general reference rate
of interest charged by the Administrative  Agent, and (b) the Federal Funds Rate
plus   one-half  of  one  percent   (.5%).   Borrower   acknowledges   that  the
Administrative Agent may, from time to time, extend credit to other borrowers at
rates of interest  varying  from,  and having no  relationship  to, such general
reference  rate.  Each change in the Alternate Base Rate shall become  effective
without prior notice to Borrower  automatically as of the opening of business on
the date of such change in the Alternate Base Rate.

     "Alternate  Base Rate Advances"  means Advances that bear interest at rates
based upon the Alternate Base Rate.

     "Applicable  Lending  Office" means for each Bank and each Type of Advance,
the lending office of such Bank (or of an Affiliate of such Bank) designated for
such  Type of  Advance  below  its  name on the  signature  pages  hereof  or an
Assignment and Acceptance, or such other office of such Bank (or of an Affiliate
of such  Bank) as such Bank may from time to time  specify to  Borrower  and the
Administrative  Agent as the office by which its Advances of such Type are to be
made and maintained.

     "Applicable  Margin" means the interest margin over the Alternate Base Rate
or the Adjusted  Eurodollar  Rate,  as the case may be, that is as follows:  (a)
from the date hereof  until  delivery of financial  statements  and a compliance
certificate for the period ending September 30, 1996, as required hereunder, (i)
one and one-quarter of one percent (1.25%) for Alternate Base Rate Advances, and
(ii) two and three-quarters of one percent (2.75%) for Eurodollar Advances;  and
(b)  thereafter,  based on the Total Debt to EBITDA Ratio as of and for the most
recent four (4) quarter  period  ending on or before the date of  determination,
the margin set forth opposite such ratio below:

                                                   Applicable
                                                     Margin          Applicable
                                                   Alternate           Margin
                                                   Base Rate         Eurodollar
          Total Debt to EBITDA Ratio                Advances          Advances
- ------------------------------------              ------------       ----------
Less than 2.0 to 1.0                                  0.5%              2.00%

                                        2

<PAGE>

Less than 2.50 to 1.0 but greater than               0.75%              2.25%
  or equal to 2.0 to 1.0
Less than 3.0 to 1.0 but greater than                1.00%              2.50%
  or equal to 2.50 to 1.0
Less than 3.50 to 1.0 but greater than               1.25%              2.75%
  or equal to 3.0 to 1.0
Greater than or equal to 3.50 to 1.0                 1.50%              3.00%


     The Total  Debt to EBITDA  Ratio  shall be  determined  from the  then-most
current of either (a) the quarterly or annual  financial  statements and related
compliance certificate delivered pursuant to Section 8.1, or (b) the most recent
Advance Request Form for a Permitted Acquisition, calculating any adjustments to
such ratio necessitated as a result of the Permitted  Acquisition for which such
Advance was made.  The  adjustment,  if any, to the  Applicable  Margin shall be
effective  commencing  on the fifth (5th)  Business  Day after  delivery of such
financial statements (and related compliance certificate) or the respective date
of Advance for a Permitted Acquisition, as the case may be. If Borrower fails at
any time to  furnish  to the  Administrative  Agent and the Banks the  financial
statements  and related  compliance  certificate  as  required  to be  delivered
pursuant to Section 8.1,  then the maximum  Applicable  Margin shall apply until
such  time as such  financial  statements  and  compliance  certificates  are so
delivered.

     "Applicable  Payment  Amount" means, as of any date, an amount equal to (a)
the aggregate  amount of Debt of the Companies,  as of such date,  minus (b) the
product of (i) EBITDA of the  Companies,  for the four (4) fiscal quarter period
immediately preceding the date of determination, and (ii) 2.75; provided that if
such Applicable  Payment Amount is less than $0.00, then the Applicable  Payment
Amount shall be $0.00.

     "Applicable  Rate"  means:  (a)  during  any  period  that an Advance is an
Alternate Base Rate Advance, the Alternate Base Rate plus the Applicable Margin;
and (b) during any period that an Advance is a Eurodollar Advance,  the Adjusted
Eurodollar Rate plus the Applicable Margin.

     "Applicable Unused Fee Percentage" means the per annum rate with respect to
the unused portion of the Revolving Credit Commitments as follows:  (a) from the
date hereof until delivery of financial statements and a compliance  certificate
for the period ending September 30, 1996, as required hereunder, one-half of one
percent (0.50%); and (b) thereafter,  based on the Total Debt to EBITDA Ratio as
of and for the most recent four (4) quarter  period ending on or before the date
of determination, the percentage set forth opposite such ratio below:


                                                   Applicable
                                                   Unused Fee
          Total Debt to EBITDA Ratio               Percentage
Less than 2.5 to 1.0                                 0.375%
Greater than or equal to 2.50 to 1.0                 0.50%


     The Applicable  Unused Fee Percentage shall be adjusted,  if necessary,  at
the same time as adjustments to the Applicable Margin.

     "Assignee" has the meaning specified in Section 13.6.

     "Assigning Bank" has the meaning specified in Section 13.6.

                                        3

<PAGE>

     "Assignment and Acceptance" means an assignment and acceptance entered into
by an Assigning Bank and its Assignee and accepted by the  Administrative  Agent
pursuant to Section 13.6, in substantially the form of Exhibit B.

     "Bank" and "Banks" have the meanings specified in the preamble.

     "Basle  Accord"  means  the  proposals  for  risk-based  capital  framework
described  by  the  Basle  Committee  on  Banking  Regulations  and  Supervisory
Practices  in  its  paper   entitled   "International   Convergence  of  Capital
Measurement and Capital Standards" dated July 1988, as amended, supplemented and
otherwise modified and in effect from time to time, or any replacement thereof.

     "Borrower  Security   Agreement"  means  the  Borrower  Security  Agreement
executed by Borrower in favor of the Administrative Agent for the benefit of the
Banks in  substantially  the  form of  Exhibit  C, as the  same may be  amended,
supplemented,  or modified from time to time, which Borrower Security  Agreement
is in renewal, amendment,  restatement and substitution of that certain Borrower
Security Agreement dated November 28, 1994, executed by Borrower in favor of the
Administrative  Agent,  for the benefit of the Banks under the  Original  Credit
Agreement,  as amended  pursuant to that First  Amendment  to Borrower  Security
Agreement dated as of August 17, 1995.

     "Business Day" means (a) any day on which the Administrative  Agent is open
for  regular  business,  and  (b)  with  respect  to all  borrowings,  payments,
Conversions,  Continuations,  Interest  Periods,  and notices in connection with
Eurodollar  Advances,  any day which is a Business  Day  described in clause (a)
above and which is also a day on which  dealings in Dollar  deposits are carried
out in the London interbank market.

     "Capital Lease  Obligations"  means,  as to any Person,  the obligations of
such Person to pay rent or other  amounts  under a lease of (or other  agreement
conveying the right to use) real and/or personal property, which obligations are
required to be  classified  and  accounted  for as a capital  lease on a balance
sheet of such Person under GAAP. For purposes of this  Agreement,  the amount of
such Capital Lease  Obligations  shall be the  capitalized  amount  thereof,  as
determined in accordance with GAAP.

     "Change  in  Control"  means the  individuals  who,  as of the date of this
Agreement,  constitute  the  members  of  Borrower's  Board  of  Directors  (the
"Incumbent  Board") do not  constitute  or cease for any reason to constitute at
least fifty percent (50%) of:

     (a) Borrower's Board of Directors; or

     (b) The  surviving  corporation's  Board of  Directors  in the event of any
merger or consolidation (if permitted by Section 9.3) involving Borrower; or

     (c) The  controlling  entity's board of directors,  the comparable  body if
there is no Board of  Directors,  or voting  control  if there is no  comparable
body,  in the event that the  surviving  corporation  under  clause (b) above is
directly or indirectly controlled by that entity.

     Any individual who becomes a member of the Board of Directors or comparable
body or who obtains a voting interest,  as applicable under clauses (a), (b), or
(c) above,  after the date of this agreement and whose appointment to the Board,
or  nomination  for  election,  was  approved  or  ratified  by a  vote  of  the
individuals  comprising  at least  fifty (50%) of the  Incumbent  Board shall be
deemed to be a member of the Incumbent Board.

     "Code"  means  the  Internal  Revenue  Code of 1986,  as  amended,  and the
regulations promulgated and rulings issued thereunder.

     "Collateral" has the meaning specified in Section 5.1.



                                        4

<PAGE>

     "Commitment"  means,  as to each Bank as of any date, the Revolving  Credit
Commitment and the Term Loan  Commitment of such Bank.  "Commitments"  means the
Revolving Credit Commitments and the Term Loan Commitments of all the Banks.

     "Companies" means Borrower and its Subsidiaries.

     "Confidential  Information"  means any and all information  relating to the
Companies,  including,  without limitation,  information relating to each of the
Company's financial condition,  business plans,  management,  earnings,  assets,
liabilities,   contracts,   processes,   products,   research  and   development
activities, intellectual property, services, customers, suppliers, marketing and
sales.  In addition,  Confidential  Information  shall include any and all other
information  marked  or  identified  in  writing  by  any of  the  Companies  as
"Confidential"  or  "Confidential  Information"  and  provided  by  each  of the
Companies or its  representatives  to any of the Banks or the Agents or obtained
by the  Banks or the  Agents  after  an  inspection  pursuant  to  Section  8.6.
Notwithstanding the foregoing, "Confidential Information" shall not include:

     (i) any information  known to an Agent or a Bank prior to disclosure by any
of the Companies or its representatives,  as documented prior to such disclosure
in such Agent's or Bank's written records;

     (ii) any information which an Agent or a Bank demonstrates became available
to it on a  non-confidential  basis  from  a  source  (other  than  any  of  the
Companies) who is not bound by a  confidentiality  agreement  with, or any other
contractual,  legal or fiduciary  obligation of  confidentiality  to, any of the
Companies or any other party with respect to such information;

     (iii) any information  which an Agent or a Bank  demonstrates is or becomes
generally  available to the public other than as a result of a disclosure  by it
in breach of Section 13.18; and

     (iv) any information which an Agent or a Bank demonstrates was conceived of
or developed by it or any of its employees without access or reference, directly
or indirectly, to the Confidential Information.

     "Consolidated Net Income" means, for any Person for any period,  the amount
which,  in  conformity  with  GAAP,  would  be shown  on a  consolidated  income
statement of such Person as net income for such period,  after  deduction of any
minority interests.

     "Consolidated  Net Worth" means, at any particular time, all amounts which,
in  conformity  with  GAAP,  would be  included  as  stockholders'  equity  on a
consolidated balance sheet of the Companies.

     "Continue,"  "Continuation,"  and  "Continued"  refers to the  continuation
pursuant to Section 2.6 of a Eurodollar  Advance from one Interest Period to the
next Interest Period.

     "Control"  means the  possession,  directly or indirectly,  of the power to
direct or cause the direction of the management or policies of a Person, whether
through the ownership of voting  securities  or other  ownership  interests,  by
contract or otherwise.  "Controlling" and "Controlled" have meanings correlative
thereto.

     "Conversion" and "Converted" refers to a conversion pursuant to Section 2.6
of one Type of Advance into another Type of Advance.

     "Debt" means as to any Person at any time (without  duplication and without
duplication  among  the  Companies):  (a) all  obligations  of such  Person  for
borrowed money;  (b) all obligations of such Person  evidenced by bonds,  notes,
debentures, or other similar instruments;  (c) all obligations of such Person to
pay the deferred  purchase price of property or services,  except trade accounts
payable of such Person  arising in the ordinary  course of business that are not
past due by more than ninety (90) days;  (d) all Capital  Lease  Obligations  of
such Person;  (e) all  indebtedness or other  obligations of others of the types
described in this definition,  if Guaranteed by such Person; (f) all obligations
secured by a Lien existing on property owned by such Person,  


                                        5

<PAGE>

whether or not the  obligations  secured  thereby have been assumed by such
Person or  arenon-recourse  to the credit of such Person;  (g) all reimbursement
obligations  of such Person  (whether  contingent  or  otherwise)  in respect of
letters of  credit,  bankers'  acceptances,  surety or other  bonds and  similar
instruments;  and (h) all  liabilities  of such  Person in respect  of  unfunded
vested benefits under any Plan; provided,  however, that the term Debt shall not
include  endorsements  of instruments  for deposit or collection in the ordinary
course of business.

     "Default"  means an  Event  of  Default  or the  occurrence  of an event or
condition  which  with the  giving of notice or the lapse of time or both  would
become an Event of Default.

     "Defaulting  Bank"  means  any  Bank  that  has  defaulted  on  any  of its
obligations under this Agreement.

     "Default Rate" means the lesser of (a) the Maximum Rate, and (b) the sum of
the  Alternate  Base Rate in effect from day to day plus the  Applicable  Margin
plus two percent (2%).

     "Documentation Agent" has the meaning specified in the preamble.

     "Dollars" and "$" mean lawful money of the United States of America.

     "EBITDA" means,  for any Person for any period,  Consolidated Net Income of
such  Person  for  such  period,  determined  after  deduction  of any  minority
interests, plus all amounts deducted therefrom during such period, in conformity
with GAAP, for interest, taxes, depreciation and amortization.

     "Eligible   Assignee"   means  any  commercial   bank,   savings  and  loan
association,  savings bank, finance company,  insurance  company,  pension fund,
mutual fund, or other financial institution (whether a corporation, partnership,
or other entity) approved by the Administrative Agent and, so long as no Default
has occurred and is continuing,  Borrower, such approvals not to be unreasonably
withheld.

     "Environmental  Laws"  means any and all  federal,  state,  and local laws,
regulations,  and requirements pertaining to health, safety, or the environment,
including,   without  limitation,  the  Comprehensive   Environmental  Response,
Compensation and Liability Act of 1980, 42 U.S.C. ss. 9601 et seq., the Resource
Conservation  and  Recovery  Act of  1976,  42  U.S.C.  ss.  6901 et  seq.,  the
Occupational  Safety and Health  Act, 29 U.S.C.  ss. 651 et seq.,  the Clean Air
Act,  42 U.S.C.  ss. 7401 et seq.,  the Clean  Water Act, 33 U.S.C.  ss. 1251 et
seq., and the Toxic Substances  Control Act, 15 U.S.C. ss. 2601 et seq., as such
laws, regulations,  and requirements may be amended or supplemented from time to
time.

     "Environmental  Liabilities"  means,  as to any  Person,  all  liabilities,
obligations,  responsibilities,  Remedial  Actions,  losses,  damages,  punitive
damages,  consequential damages, treble damages, costs, and expenses (including,
without limitation,  all reasonable fees, disbursements and expenses of counsel,
expert and consulting fees and costs of investigation and feasibility  studies),
fines, penalties,  sanctions,  and interest incurred as a result of any claim or
demand,  by any Person,  whether  based in  contract,  tort,  implied or express
warranty,   strict   liability,   criminal  or  civil  statute,   including  any
Environmental Law, permit, order or agreement with any Governmental Authority or
other Person,  arising from  environmental,  health or safety  conditions or the
Release or  threatened  Release of a Hazardous  Material  into the  environment,
resulting  from the past,  present,  or future  operations of such Person or its
Affiliates.

     "ERISA"  means the Employee  Retirement  Income  Security  Act of 1974,  as
amended from time to time,  and the  regulations  and published  interpretations
thereunder.

     "ERISA  Affiliate"  means any  corporation  or trade or business which is a
member of the same  controlled  group of  corporations  (within  the  meaning of
Section 414(b) of the Code) as Borrower or is under common  control  (within the
meaning of Section 414(c) of the Code) with Borrower.


                                        6

<PAGE>

     "Eurodollar  Advances"  means  Advances  the  interest  rates on which  are
determined on the basis of the rates  referred to in the definition of "Adjusted
Eurodollar Rate" in this Section 1.1.

     "Eurodollar Rate" means, for any Eurodollar Advance for any Interest Period
therefor,  the rate per annum  (rounded  upwards,  if necessary,  to the nearest
0.01%) quoted by the  Administrative  Agent at  approximately  11:00 a.m. London
time (or as soon thereafter as  practicable)  two (2) Business Days prior to the
first (1st) day of such Interest  Period for the offering by the  Administrative
Agent to leading  banks in the London  interbank  market of Dollar  deposits  in
immediately available funds having a term comparable to such Interest Period and
in an amount  comparable to the principal amount of the Eurodollar  Advance made
by the  Administrative  Agent to which  such  Interest  Period  relates.  If the
Administrative  Agent is not participating in any Eurodollar Advances during any
Interest Period therefor (pursuant to Section 4.4 or for any other reason),  the
Adjusted  Eurodollar  Rate for such Advances for such  Interest  Period shall be
determined by reference to the amount of the Advances  which the  Administrative
Agent would have made had it been participating in such Advances.

     "Event of Default" has the meaning specified in Section 11.1.

     "Excess Cash Flow" means, for any quarterly period,  (a) EBITDA,  minus (b)
total cash income tax expense  actually  paid during such period,  minus (c) the
aggregate  amount of any optional  prepayments  of the  Obligations  during such
period,  minus (d)  scheduled  principal  payments in respect of all Debt during
such period,  minus (e) total  consolidated  interest  expense in respect of all
Debt  actually  paid or that is payable  during such  period,  minus (f) capital
expenditures  during such period (provided that such capital  expenditures shall
not  exceed  (x)  $2,000,000.00  minus  (y)  the  aggregate  amount  of  capital
expenditures during the three (3) fiscal quarters ending prior to such quarterly
fiscal period).

     "Federal  Funds  Rate"  means,  for any day,  the rate per  annum  (rounded
upwards,  if necessary,  to the nearest 0.01%) equal to the weighted  average of
the rates on overnight  Federal funds  transactions  with members of the Federal
Reserve  System  arranged by Federal  funds brokers on such day, as published by
the Federal  Reserve Bank of New York on the Business Day next  succeeding  such
day, provided that (a) if the day for which such rate is to be determined is not
a Business  Day, the Federal  Funds Rate for such day shall be such rate on such
transactions  on the next  preceding  Business  Day as so  published on the next
succeeding  Business  Day, and (b) if such rate is not so published on such next
succeeding Business Day, the Federal Funds Rate for any day shall be the average
rate charged to the  Administrative  Agent on such day on such  transactions  as
determined by the Administrative Agent.

     "FNBB" has the meaning specified in the preamble.

     "GAAP"  means  generally  accepted  accounting  principles,  applied  on  a
consistent basis, as set forth in Opinions of the Accounting Principles Board of
the American  Institute of Certified Public  Accountants and/or in statements of
the Financial Accounting Standards Board and/or their respective  successors and
which are applicable in the circumstances as of the date in question. Accounting
principles are applied on a "consistent  basis" when the  accounting  principles
applied in a current  period are  comparable  in all material  respects to those
accounting principles applied in a preceding period, except for changes required
by GAAP.

     "Governmental  Authority"  means  any  nation or  government,  any state or
political subdivision thereof and any entity exercising executive,  legislative,
judicial,   regulatory,   or  administrative   functions  of  or  pertaining  to
government.

     "Governmental  Authorization"  shall mean any approval,  consent,  license,
permit, waiver, or other authorization issued, granted, given, or otherwise made
available by or under the authority of any Governmental Authority or pursuant to
any Legal Requirement.

     "Guarantee" by any Person means any obligation, contingent or otherwise, of
such Person directly or indirectly  guaranteeing any Debt or other obligation of
any other Person and,  without  limiting the  generality of the  foregoing,  any
obligation,  direct or indirect,  contingent or otherwise, of such Person (a) to
purchase or pay (or advance or supply funds for the purchase or payment of) such
Debt or other obligation (whether arising by virtue of partnership arrangements,
by agreement to

                                        7

<PAGE>




keep-well, to purchase assets, goods, securities or services, to take-or-pay, or
to maintain financial  statement  conditions or otherwise),  or (b) entered into
for the  purpose of  assuring  in any other  manner the  obligee of such Debt or
other  obligation of the payment  thereof or to protect the obligee against loss
in respect  thereof (in whole or in part),  provided  that the term  "Guarantee"
shall not include  endorsements for collection or deposit in the ordinary course
of business. The term "Guarantee" used as a verb has a corresponding meaning.

     "Guaranties" means,  collectively,  the Guaranty Agreements executed by the
Guarantors in favor of the Agents and the Banks,  each in substantially the form
of Exhibit D, which Guaranty Agreements are in renewal, amendment,  substitution
and replacement of the Guaranty  Agreements executed by the Guarantors under the
Original Credit Agreement in favor of the Agent and the Banks under the Original
Credit Agreement. "Guaranty" means any one of the Guaranties.

     "Guarantors"  means,   collectively,   all  Wholly-Owned   Subsidiaries  of
Borrower,  now  owned  or  hereafter  acquired  or  formed,  including,  without
limitation,  the Subsidiaries listed on Schedule 2. "Guarantor" means any one of
the Guarantors.

     "Guarantor  Security  Agreements" means the Security Agreements executed by
the  Guarantors  in favor of the  Administrative  Agent,  for the benefit of the
Banks,  in  substantially  the form of  Exhibit  E, as the same may be  amended,
supplemented  or modified from time to time,  which  Security  Agreements are in
renewal,  amendment,  restatement and  substitution  of the Security  Agreements
executed by the Guarantors  under the Original Credit  Agreement in favor of the
Administrative  Agent,  for the benefit of the Banks under the  Original  Credit
Agreement.  "Guarantor  Security  Agreement"  means  any  one of  the  Guarantor
Security Agreements.

     "Hazardous  Material"  means  any  substance,  product,  waste,  pollutant,
material,  chemical,  contaminant,  constituent,  or other  material which is or
becomes listed,  regulated, or addressed under any Environmental Law, including,
without limitation, asbestos, petroleum, and polychlorinated biphenyls.

     "Hedging Agreement" has the meaning specified in Section 11.1.

     "Interest  Coverage Ratio" means,  as to the Companies for any period,  (a)
EBITDA for such  period  divided  by (b) the  aggregate  amount of  consolidated
interest expense for such period, all as determined in accordance with GAAP.

     "Interest  Period"  means,  with respect to any  Eurodollar  Advance,  each
period  commencing on the date such Advance is made or Converted from an Advance
of another Type or, in the case of each subsequent,  successive  Interest Period
applicable to a Eurodollar Advance,  the last day of the next preceding Interest
Period with respect to such Advance, and ending on the numerically corresponding
day in the first (1st),  second (2nd), third (3rd) or sixth (6th) calendar month
thereafter,  as Borrower  may select as  provided in Section 2.5 or 2.6,  except
that each such  Interest  Period which  commences on the last  Business Day of a
calendar  month (or on any day for which there is no  numerically  corresponding
day in the appropriate subsequent calendar month) shall end on the last Business
Day of the appropriate subsequent calendar month. Notwithstanding the foregoing:
(a) each  Interest  Period  which  would  otherwise  end on a day which is not a
Business  Day  shall  end on the  next  succeeding  Business  Day  (or,  if such
succeeding Business Day falls in the next succeeding calendar month, on the next
preceding  Business Day); (b) any Interest Period which would  otherwise  extend
beyond the Termination Date shall end on the Termination  Date; (c) no more than
six (6)  Interest  Periods  shall  be in  effect  at the same  time;  and (d) no
Interest  Period  shall have a duration  of less than one (1) month and,  if any
Interest Period would otherwise be a shorter period,  such Advances shall not be
available hereunder.

     "Issuance  Proceeds"  means the net proceeds of (i) any sale or issuance of
Borrower's  capital  stock,  or (ii)  the  incurrence  of any  Debt of the  type
described in subsections  (a) and (b) of the definition of Debt, in each case to
the extent  permitted  hereunder;  provided that "Issuance  Proceeds " shall not
include proceeds from the exercise of any warrants issued to Alabama Lithotripsy
Joint Venture to the extent such warrant proceeds are contemporaneously  used to
pay outstanding Debt to Alabama Lithotripsy Joint Venture.


                                        8

<PAGE>




     "Legal  Requirement"  shall  mean any  federal,  state,  local,  municipal,
foreign,   international,   multinational,   or  other   administrative   order,
constitution,  law, ordinance, principle of common law, regulation,  statute, or
treaty as in effect on the date hereof.

     "Lien" means any lien,  mortgage,  security interest,  tax lien,  financing
statement, pledge, charge, hypothecation,  assignment,  preference, priority, or
other  encumbrance  of  any  kind  or  nature  whatsoever  (including,   without
limitation, any conditional sale or title retention agreement),  whether arising
by contract, operation of law, or otherwise.

     "Litho" means Lithotripters, Inc., a North Carolina corporation.

     "Loan  Documents"  means this Agreement,  the Notes,  the  Guaranties,  the
Borrower  Security  Agreement,  the Guarantor  Security  Agreements,  the Pledge
Agreements,  any  Hedging  Agreement  between the  Administrative  Agent and the
Documentation  Agent,  and all  other  instruments,  documents,  and  agreements
executed and delivered pursuant to or in connection with this Agreement, as such
instruments,  documents,  and  agreements  may be  amended,  modified,  renewed,
extended, or supplemented from time to time.

     "Material  Subsidiary"  means,  as of any date, (a) any  Subsidiary  which,
together with its  Subsidiaries,  accounts for three percent (3%) or more of the
Company's  consolidated  gross  revenues or assets,  or (b) any  combination  of
Subsidiaries which, together with their Subsidiaries,  account for seven percent
(7%) or more of the Company's  consolidated  gross  revenues or assets,  in each
case on a consolidated basis (but without elimination of any minority interests)
as of and for the most  recent  fiscal  quarter  for which such  information  is
available. "Material Subsidiaries" means all of the Material Subsidiaries.

     "Maximum Rate" means, at any time and with respect to any Bank, the maximum
rate of interest under  applicable law that such Bank may charge  Borrower.  The
Maximum Rate shall be calculated in a manner that takes into account any and all
fees,  payments,  and  other  charges  in  respect  of the Loan  Documents  that
constitute  interest  under  applicable  law.  Each change in any interest  rate
provided for herein based upon the Maximum Rate  resulting  from a change in the
Maximum  Rate shall take effect  without  notice to Borrower at the time of such
change in the Maximum Rate.

     "Multiemployer Plan" means a multiemployer plan as defined in Section 3(37)
of ERISA  to  which  contributions  have  been  made by  Borrower  or any  ERISA
Affiliate of Borrower and which is covered by Title IV of ERISA.

     "NationsBank" has the meaning specified in the preamble.

     "Notes" means the Revolving  Credit Notes and the Term Notes.  "Note" means
any one of the Notes.

     "Obligated Party" means any Person who is or becomes party to any agreement
that  guarantees or secures  payment and  performance of the  Obligations or any
part thereof.

     "Obligations"  means all  obligations,  indebtedness,  and  liabilities  of
Borrower to the Agents and the Banks, or any of them, arising pursuant to any of
the Loan Documents, now existing or hereafter arising, whether direct, indirect,
related, unrelated, fixed, contingent, liquidated, unliquidated, joint, several,
or joint and several,  and all interest accruing thereon and all attorneys' fees
and other expenses incurred in the enforcement or collection thereof.

     "Original Credit Agreement" has the meaning specified in the recitals.

     "Partnerships"  means the  partnerships in which Borrower or any Subsidiary
now owns or hereafter acquires general and/or limited partnership  interests and
the other  Persons in which  Borrower or any  Subsidiary  now owns or  hereafter
acquires ownership interests,  including,  without limitation,  the partnerships
and other  Persons  listed on  Schedule  3.  "Partnership"  means any one of the
Partnerships.


                                        9

<PAGE>




     "Payment  Date" means (a) with respect to Alternate  Base Rate Advances and
the commitment fees payable pursuant to Section 2.8(a), the last Business Day of
each April,  July,  October and January,  commencing June 30, 1996, and (b) with
respect to  Eurodollar  Advances,  the last day of the respect  Interest  Period
therefor, provided that if any Interest Period is greater than three (3) months,
then  accrued  interest  shall  also be due and  payable  shall  also be due and
payable  on the date that is three (3)  months  after the  commencement  of such
Interest Period.

     "PBGC"  means  the  Pension  Benefit  Guaranty  Corporation  or any  entity
succeeding to all or any of its functions under ERISA.

     "Permitted  Acquisition"  means an  Acquisition  by  Borrower or any of its
Subsidiaries  with respect to which each of the following  conditions shall have
been satisfied:

     (a) the Acquisition by Borrower or such Subsidiary is of a business, assets
or Person (as applicable,  the "Target") which is engaged in  substantially  the
same  business as the business  conducted by Borrower or such  Subsidiary on the
date hereof, or any other business reasonably related thereto;

     (b) as of the  closing  of  such  Acquisition,  the  Acquisition  has  been
approved and recommended by the board of directors or other applicable governing
body of the Target and the Person from which the Target is to be acquired;

     (c) prior to the  closing  of such  acquisition,  the Target and the Person
from which the Target is to be acquired must be Solvent;

     (d) as of the  closing of such  Acquisition,  after  giving  effect to such
Acquisition,  Borrower or the  Subsidiary  that is the  acquiring  party must be
Solvent and the Companies, on a consolidated basis, must be Solvent;

     (e) as of the  closing of such  Acquisition,  after  giving  effect to such
Acquisition,  no Default  shall exist or occur as a result of, and after  giving
effect to, such Acquisition;

     (f) the aggregate  purchase price with respect to such Acquisition does not
exceed five (5) times EBITDA of the Target, subject to adjustments acceptable to
the Administrative Agent where less than all of the business, assets or stock of
the Target is acquired,  acquired  pursuant to the  Acquisition for the four (4)
fiscal  quarters  ending on the most  recently  ended fiscal period prior to the
date of such Acquisition;

     (g) the aggregate cash  consideration  for such Acquisition does not exceed
$10,000,000.00 and the aggregate cash consideration for all Acquisitions  (other
than  the  Acquisition  of  additional  limited  partnership  interests  of  the
Partnerships  in which Litho is, as of the date  hereof,  the  general  partner)
during the  immediately  preceding  twelve  (12) month  period  (including  such
Acquisition) does not exceed $20,000,000.00;

     (h) after giving  effect to such  Acquisition,  the  aggregate  Debt of the
Companies  (without  deduction  for any minority  interests  and  including  any
Advances under the Revolving Credit  Commitments) does not exceed the product of
(1) EBITDA of the Companies  (including  EBITDA for the Target acquired pursuant
to the  Acquisition)  for the four (4) fiscal  quarters ending on the closing of
the Acquisition, and (2) 2.75;

     (i) the  Administrative  Agent  shall  have  received  pro forma  financial
statements of the Companies (as if the business,  assets or Person  acquired had
been  acquired  since the first (1st) day of the period for which such pro forma
financial  statements are  delivered) for the prior four (4) fiscal  quarters of
Borrower and the Companies;

     (j) if the  Target is to be an  After-Acquired  Subsidiary,  then  Borrower
shall have complied with the terms and conditions set forth in Section 8.13; and


                                       10

<PAGE>




     (k) the  Administrative  Agent has received a certificate,  executed by the
President or a Vice President of Borrower  confirming  that all  representations
and warranties  set forth in the Loan Documents  continue to be true and correct
in all material  respects  immediately  prior to and after giving  effect to the
Permitted  Acquisition and the transactions  contemplated  thereby,  and setting
forth the  calculations  supporting  compliance with the limitations  prescribed
herein.

     "Person" means any individual,  corporation,  business trust,  association,
company, partnership, joint venture, Governmental Authority, or other entity.

     "Plan" means any employee  benefit or other plan  established or maintained
by Borrower or any ERISA  Affiliate of Borrower and which is covered by Title IV
of ERISA.

     "Pledge  Agreements" means the Pledge  Agreements  executed by Borrower and
each  Subsidiary  of  Borrower  that owns  general  and/or  limited  partnership
interests in the  Partnerships  in favor of the  Administrative  Agent,  for the
benefit of the Banks, substantially in the form of Exhibit F, as the same may be
amended,  supplemented or modified from time to time.  "Pledge  Agreement" means
any one of the Pledge Agreements.

     "Pledgors" means each of the pledgors of partnership  interests pursuant to
a Pledge Agreement. "Pledgor" means any one of the Pledgors.

     "Principal Office" means the principal office of the Administrative  Agent,
presently located at 100 Federal Street, Boston, Massachusetts 02110.

     "Prohibited  Transaction" means any transaction set forth in Section 406 of
ERISA or Section 4975 of the Code.

     "Regulation D" means  Regulation D of the Board of Governors of the Federal
Reserve System as the same may be amended or supplemented from time to time.

     "Regulatory  Change" means,  with respect to any Bank, any change after the
date of this  Agreement  in United  States  federal,  state,  or foreign laws or
regulations  (including  Regulation D) or the adoption or making after such date
of any  interpretations,  directives,  or requests  applying to a class of banks
including  such Bank of or under any United States  federal,  state,  or foreign
laws or  regulations  (whether  or not  having the force of law) by any court or
governmental  or  monetary   authority   charged  with  the   interpretation  or
administration thereof.

     "Release" means, as to any Person, any release,  spill, emission,  leaking,
pumping, injection, deposit, disposal,  disbursement,  leaching, or migration of
Hazardous  Materials  into the indoor or outdoor  environment  or into or out of
property owned by such Person,  including,  without limitation,  the movement of
Hazardous Materials through or in the air, soil, surface water, ground water, or
property.

     "Remedial  Action"  means all  actions  required  to (a) clean up,  remove,
treat,  or  otherwise  address  Hazardous  Materials  in the  indoor or  outdoor
environment,  (b)  prevent  the  Release or threat of Release  or  minimize  the
further  Release of Hazardous  Materials so that they do not migrate or endanger
or  threaten  to  endanger  public  health or  welfare  or the indoor or outdoor
environment,   or  (c)  perform  pre-remedial  studies  and  investigations  and
post-remedial monitoring and care.

     "Required  Banks" means,  as of any date,  any  combination of Banks (other
than any Defaulting  Banks) who collectively hold sixty percent (60%) of the sum
of (a) the Revolving Credit Commitments (other than of any Defaulting Banks), or
if the Revolving  Credit  Commitments  shall have been  terminated,  then of the
aggregate  unpaid  principal amount of the Revolving Credit Notes (other than of
any Defaulting Banks), and (b) the aggregate unpaid principal amount of the Term
Notes (other than of any Defaulting Banks).

     "Reportable  Event"  means any of the events  set forth in Section  4043 of
ERISA.

                                       11

<PAGE>




     "Reserve  Requirement"  means, for any Eurodollar  Advance for any Interest
Period  therefor,  the average rate at which  reserves  (including any marginal,
supplemental  or emergency  reserves) are required to be maintained  during such
Interest  Period under  Regulation D by each Bank on its portion of such Advance
against "Eurocurrency Liabilities" as such term is used in Regulation D. Without
limiting the effect of the foregoing,  the Reserve Requirement shall reflect any
other  reserves  required to be maintained by a Bank by reason of any Regulatory
Change  against  (i) any  category of  liabilities  which  includes  deposits by
reference to which the Adjusted Eurodollar Rate is to be determined, or (ii) any
category  of  extensions  of credit or other  assets  which  include  Eurodollar
Advances.

     "Revolving  Credit  Commitment"  means, as to each Bank as of any date, the
obligation of such Bank on such date to make Advances  hereunder in an aggregate
principal  amount at any time  outstanding  up to but not  exceeding  the amount
shown on  Schedule  1 as its  Revolving  Credit  Commitment,  as the same may be
reduced  pursuant to Section 2.1(c) or terminated  pursuant to Section 2.1(c) or
Section 11.2 and as the same may be increased or decreased  from time to time by
further  assignment  pursuant to Section 13.6.  "Revolving  Credit  Commitments"
means the  Revolving  Credit  Commitments  of all of the  Banks in the  original
aggregate amount of $40,000,000.00.

     "Revolving  Credit Loan" means all Advances  with respect to the  Revolving
Credit Commitment, evidenced by the Revolving Credit Notes.

     "Revolving Credit Note" means a revolving credit note executed by Borrower,
substantially  in the form of Exhibit G, payable to each Bank in an amount equal
to  such  Bank's  Revolving  Credit  Commitment,  as the  same  may be  amended,
supplemented,  modified or restated from time to time, evidencing the obligation
of Borrower to repay the Revolving Credit Loan, and all renewals,  modifications
and  extensions  thereof.  "Revolving  Credit  Notes" means all of the Revolving
Credit Notes of the Banks.

     "RICO" means the Racketeer Influenced and Corrupt Organization Act of 1970,
as amended from time to time.

     "Solvent"  means,  with  respect  to  any  Person,  that  on  the  date  of
determination  (a) the fair market value of its assets is greater than the total
amount of liabilities,  including, without limitation, contingent liabilities of
such Person which would be required to be included on the balance  sheet of such
Person or disclosed in the  financial  statements  of such Person in  accordance
with GAAP,  (b) the present fair  salable  value of the assets of such Person is
not less than the amount that will be required to pay the probable  liability of
such Person on its debts as they become  absolute and  matured,  (c) such Person
does not intend to, and does  believe that it will,  incur debts or  liabilities
beyond such Person's  ability to pay as such debts and liabilities  mature,  and
(d) such Person is not engaged in business or transactions,  and is not about to
engage in business or  transactions,  for which its assets would  constitute  an
unreasonably small capital.

     "Subsidiary"   means,   with  respect  to  any  Person,   any  corporation,
partnership,  association,  or other business entity (a) of which  securities or
other  ownership  interests  representing  more than fifty  percent (50%) of the
equity or more than fifty  percent  (50%) of the  ordinary  voting power or more
than fifty percent (50%) of the general  partnership  interests are, at the time
any determination is made, owned, Controlled or held by such Person, or (b) that
is, at the time any determination is made,  otherwise  Controlled by one or more
Subsidiaries  of such Person or by such Person and one or more  Subsidiaries  of
such Person.

     "Syndication Agent" has the meaning specified in the preamble.

     "Termination Date" means 1:00 p.m. Boston,  Massachusetts time on April 30,
2001,  or such  earlier  date and time on which  the  Commitments  terminate  as
provided in this Agreement.

     "Term  Loan"  means the  $50,000,000.00  term  loan  facility  provided  to
Borrower by the Banks hereunder.

     "Term Loan  Commitment"  means, as to each Bank as of the date hereof,  the
obligation of such Bank on such date to make Advances  hereunder in an aggregate
principal  amount up to but not  exceeding the amount shown on Schedule 1 hereto
as its Term Loan Commitment, as the same may be increased or decreased from time
to time by further assignment pursuant

                                       12

<PAGE>




to Section 13.6. "Term Loan Commitments" means the Term Loan Commitments of
all of the Banks in the original aggregate amount of $50,000,000.00.

     "Term  Note"  means  a  term   promissory   note   executed  by   Borrower,
substantially  in the form of Exhibit H, payable to each Bank in an amount equal
to such Bank's Term Loan Commitment,  as the same may be amended,  supplemented,
modified or restated from time to time, evidencing the obligation of Borrower to
repay the Term Loan, and all renewals,  modifications  and  extensions  thereof.
"Term Notes" means all of the Term Notes of the Banks.

     "Total Debt Service  Coverage  Ratio"  means,  as to the  Companies for any
period,  (a) the sum of EBITDA for such period,  minus the  aggregate  amount of
capital  expenditures  made  during such  period,  divided by (b) the sum of all
principal  and interest  payments  payable  during such period in respect of all
Debt of the Companies  (without  deduction for any minority  interests),  all as
determined  on a rolling four (4) quarter and  consolidated  basis in accordance
with GAAP.

     "Total  Debt  to  EBITDA"  means,  as of any  date,  the  ratio  of (a) the
aggregate  amount of Debt of the Companies  (without  deduction for any minority
interests),  as of such date, to (b) EBITDA of the  Companies,  for the four (4)
fiscal quarter period ending on the date of determination.

     "Type"  means any type of Advance  (i.e.,  Alternate  Base Rate  Advance or
Eurodollar Advance).

     "UCC" means the Uniform Commercial Code as in effect in the Commonwealth of
Massachusetts or other applicable jurisdiction, as amended.

     "Wholly-Owned  Subsidiaries"  means, as of any date, all Subsidiaries  that
are  wholly-owned  by  Borrower  or a  wholly-  owned  Subsidiary  of  Borrower.
"Wholly-Owned Subsidiary" means any one of the Wholly-Owned Subsidiaries.

     Section 1.3    Other Definitional Provisions.  
                    ------------------------------

     All definitions  contained in this Agreement are equally  applicable to the
singular and plural forms of the terms defined.  The words  "hereof,"  "herein,"
and "hereunder" and words of similar import referring to this Agreement refer to
this Agreement as a whole and not to any particular provision of this Agreement.
Unless  otherwise  specified,   all  Article,   Section,  Exhibit  and  Schedule
references  pertain to this  Agreement.  All accounting  terms not  specifically
defined  herein  shall be  construed  in  accordance  with GAAP.  All  financial
covenants  and related  definitions  relating  to the  Companies  shall,  unless
otherwise  indicated,  be determined after deduction of any minority  interests,
provided that all references to "Debt" shall include all Debt without  deduction
for any  minority  interests.  Terms used  herein  that are  defined in the UCC,
unless otherwise defined herein, shall have the meanings specified in the UCC.

                                   ARTICLE II

                                    ADVANCES

     Section 2.1 Commitments.
                 -----------
     (a) Revolving  Credit  Commitments.  Subject to the terms and conditions of
this Agreement,  each Bank hereby  severally agrees to make one or more Advances
to Borrower from time to time from the date hereof to the Termination Date in an
aggregate  principal  amount at any time outstanding up to but not exceeding the
amount of such Bank's Revolving Credit Commitment as then in effect.  Subject to
the foregoing limitations, and the other terms and provisions of this Agreement,
Borrower may borrow,  repay, and reborrow  hereunder the amount of the Revolving
Credit Commitments by means of Eurodollar  Advances (or, in the event Eurodollar
Advances are unavailable  hereunder,  Alternate Base Rate Advances when required
or permitted by Article IV).

     (b) Term Loan  Commitments.  Subject  to the terms and  conditions  of this
Agreement,  each  Bank  hereby  severally  agrees  to make a single  Advance  to
Borrower,  on or about the date of this Agreement,  in the amount of such Bank's
Term Loan Commitment. Borrower may not borrow, repay, and reborrow hereunder any
portion of the amount of the Term Loan.

                                       13

<PAGE>




     (c) Optional  Reduction and  Termination of Revolving  Credit  Commitments.
Borrower shall have the right to terminate in whole or reduce in part the unused
portion of the  Revolving  Credit  Commitments  upon at least three (3) Business
Days'  prior  written  notice  (which  notice  shall  be   irrevocable)  to  the
Administrative   Agent   specifying  the  effective  date  thereof,   whether  a
termination or reduction is being made, and the amount of any partial reduction,
provided that each partial  reduction shall be in the amount of $1,000,000.00 or
a greater integral multiple thereof and Borrower shall simultaneously prepay the
amount by which  the  unpaid  principal  amount of the  Revolving  Credit  Notes
exceeds the Revolving  Credit  Commitments  (after giving effect to such notice)
plus accrued and unpaid interest on the principal amount so prepaid.  No portion
of  the  Revolving  Credit  Commitments  may be  reinstated  after  it has  been
terminated or reduced.

     Section 2.2    Notes.
                    ------
     
     (a) Revolving  Credit Notes.  The obligation of Borrower to repay each Bank
for  Advances  made by  such  Bank  pursuant  to such  Bank's  Revolving  Credit
Commitment,  and all interest thereon,  shall be evidenced by a Revolving Credit
Note dated the date  hereof,  executed by  Borrower  and payable to the order of
such Bank in the  original  principal  amount of such  Bank's  Revolving  Credit
Commitment.

     (b) Term Notes.  The obligation of Borrower to repay each Bank for Advances
made by such Bank pursuant to such Bank's Term Loan Commitment, and all interest
thereon,  shall be evidenced  by a Term Note dated the date hereof,  executed by
Borrower and payable to the order of such Bank in the original  principal amount
of such Bank's Term Loan Commitment.

     Section 2.3    Repayment of Advances.
                    ----------------------

     (a) Revolving Credit Notes.  Borrower shall repay the outstanding principal
amount of the Revolving Credit Notes on the Termination Date.

     (b) Term Notes.  Borrower shall repay the outstanding  principal  amount of
the Term Notes as follows: (i) in one (1) installment,  on July 31, 1996, in the
amount of  $1,000,000.00;  (ii) in seven (7) equal  quarterly  installments,  on
October 31, 1996,  January 31, 1997, April 30, 1997, July 31, 1997,  October 31,
1997, January 31, 1998, and April 30, 1998, each in the amount of $2,000,000.00;
(iii) in four (4) equal quarterly  installments,  on July 31, 1998,  October 31,
1998,  January 31, 1999 and April 30, 1999, each in the amount of $2,500,000.00;
and (iv) in eight (8) equal quarterly  installments,  on July 31, 1999,  October
31, 1999,  January 31, 2000,  April 30, 2000,  July 31, 2000,  October 31, 2000,
January  31,  2001  and  on  the  Termination   Date,  each  in  the  amount  of
$3,125,000.00.

     Section 2.4    Interest.  
                    ---------

     The  unpaid  principal  amount of all  Advances  shall bear  interest  at a
varying  rate per annum  equal from day to day to the lesser of (a) the  Maximum
Rate, or (b) the  Applicable  Rate. If at any time the  Applicable  Rate for any
Advance shall exceed the Maximum Rate,  thereby causing the interest accruing on
such Advance to be limited to the Maximum Rate, then any subsequent reduction in
the  Applicable  Rate for such Advance  shall not reduce the rate of interest on
such  Advance  below the  Maximum  Rate until the  aggregate  amount of interest
accrued on such Advance equals the aggregate amount of interest which would have
accrued on such Advance if the Applicable  Rate had at all times been in effect.
Accrued  and unpaid  interest on the  Advances  shall be due and payable on each
Payment Date and on the Termination  Date.  Notwithstanding  the foregoing,  any
outstanding  principal  of any Advance and (to the fullest  extent  permitted by
law) any other amount payable by Borrower under this Agreement or any other Loan
Document  that is not paid in full  when due  (whether  at stated  maturity,  by
acceleration,  or  otherwise)  shall bear  interest at the Default  Rate for the
period from and  including  the due date thereof to but  excluding  the date the
same is paid in full. Interest payable at the Default Rate shall be payable from
time to time on demand.

     Section 2.5    Borrowing Procedure.
                    --------------------

     (a) Revolving  Credit Loan.  Borrower shall give the  Administrative  Agent
notice by means of an Advance  Request Form of each requested  Advance under the
Revolving Credit Commitments hereunder at least two (2) Business Days before the
requested  date of each  Eurodollar  Advance  (and at least one (1) Business Day
before the requested date of each Alternate Base

                                       14

<PAGE>




Rate Advance),  specifying:  (a) the requested date of such Advance (which shall
be a Business Day); (b) the amount of such Advance;  and (c) the duration of the
Interest Period for such Advance (if a Eurodollar  Advance).  The Administrative
Agent at its  option may  accept  telephonic  requests  for  Advances  under the
Revolving Credit Commitments, provided that such acceptance shall not constitute
a waiver of the  Administrative  Agent's right to delivery of an Advance Request
Form  in  connection  with  subsequent   Advances  under  the  Revolving  Credit
Commitments.  Any telephonic  request for an Advance under the Revolving  Credit
Commitments by Borrower shall be promptly  confirmed by submission of a properly
completed Advance Request Form to the  Administrative  Agent. Each Advance under
the  Revolving  Credit  Commitments  shall be in a minimum  principal  amount of
$1,000,000.00  or a greater  integral  multiple  thereof,  provided that if such
Advance equals the entire  remaining  unfunded  portion of the Revolving  Credit
Commitments,  it may be for  any  amount.  The  aggregate  principal  amount  of
Eurodollar  Advances  having the same Interest Period shall be at least equal to
$2,500,000.00 or a greater integral multiple of $500,000.00.

     (b) Term Loan. Borrower shall give the Administrative Agent notice by means
of an  Advance  Request  Form  of  the  initial  Advance  under  the  Term  Loan
Commitments  hereunder at least two (2) Business Days before the requested  date
thereof,  specifying:  (a) the requested  date of such Advance (which shall be a
Business  Day);  (b) the amount of such  Advance;  and (c) the  duration  of the
Interest Period for such Advance (if a Eurodollar Advance).

     (c)  Generally.  The  Administrative  Agent  shall  notify each Bank of the
contents  of each  Advance  Request  Form.  Not later than  11:00  a.m.  Boston,
Massachusetts time on the date specified for each Advance  hereunder,  each Bank
will make  available  to the  Administrative  Agent at the  Principal  Office in
immediately available funds, for the account of Borrower,  its pro rata share of
each Advance. After the Administrative Agent's receipt of such funds and subject
to the other terms and conditions of this Agreement,  the  Administrative  Agent
will  make each  Advance  available  to  Borrower  by  depositing  the same,  in
immediately  available funds, in a deposit account of Borrower maintained at the
Documentation  Agent.  All notices under this Section shall be  irrevocable  and
shall be given not later than 11:00 a.m. Boston,  Massachusetts  time on the day
which is not less than the  number of  Business  Days  specified  above for such
notice.

     Section 2.6    Continuations; Conversions.
                    ---------------------------

     (a)  Continuations.  Borrower  shall have the right to Continue  Eurodollar
Advances by giving the Administrative  Agent written notice specifying:  (i) the
Continuation date; (ii) the amount of the Advance to be Continued; and (iii) the
duration of the  Interest  Period  applicable  thereto,  which  notice  shall be
irrevocable  and must be given by  Borrower  not later than  11:00 a.m.  Boston,
Massachusetts time at least two (2) Business Days before each such Continuation.
The Administrative Agent shall promptly notify each Bank of the contents of each
such notice. If Borrower shall fail to give the Administrative  Agent the notice
as specified above for Continuation of a Eurodollar  Advance prior to the end of
the  Interest  Period  applicable  thereto,  such  Eurodollar  Advance  shall be
automatically Continued for a one (1) month Interest Period.

     (b) Conversions. Borrower shall have the right to Convert an Alternate Base
Rate  Advance at any time to a Eurodollar  Advance by giving the  Administrative
Agent written notice specifying: (i) the Conversion Date; (ii) the amount of the
Advance  to be  Converted;  and  (iii)  the  duration  of  the  Interest  Period
applicable  thereto,  which  notice  shall be  irrevocable  and must be given by
Borrower not later than 11:00 a.m. Boston,  Massachusetts  time at least two (2)
Business  Days  before  each such  Conversion.  The  Administrative  Agent shall
promptly notify each Bank of the contents of each such notice.

     (c) Default.  After the occurrence and during the continuance of a Default,
no  outstanding  Advances may be Converted  into,  or Continued as, a Eurodollar
Advance.

     Section 2.7    Use of Proceeds.
                    ----------------

     (a)  Revolving  Credit Loan.  The proceeds of Advances  under the Revolving
Credit  Commitments  shall be used by Borrower  (i) for  working  capital in the
ordinary course of business, (ii) to purchase, refurbish or replace equipment to
be utilized in lithotripsy operations, (iii) to finance the Acquisition of Litho
and to finance  Permitted  Acquisitions,  (iv) to the extent  permitted  by this
Agreement,  to repurchase outstanding capital stock of Borrower, and (v) to make
loans or capital contributions

                                       15

<PAGE>




to its  Subsidiaries  the proceeds of which are used by each such Subsidiary for
one or more of the purposes  permitted by Subsections (i), (ii), (iii), and (iv)
of this Section 2.7(a).

     (b) Term Loan.  The  proceeds of Advances  under the Term Loan  Commitments
shall be used by Borrower to finance the Acquisition of Litho.

     Section 2.8    Fees.
                    -----

     (a) Borrower  hereby  agrees to pay to the  Administrative  Agent,  for the
ratable  account of each Bank,  a  commitment  fee on the daily  average  unused
amount of such  Bank's  Revolving  Credit  Commitment  for the  period  from and
including the date of this Agreement to but excluding the  Termination  Date, at
the per annum rate equal to the  Applicable  Unused  Fee  Percentage  based on a
365-day or  366-day  year,  as the case may be,  and the  actual  number of days
elapsed.  Accrued  commitment  fees shall be payable in arrears on each  Payment
Date and on the Termination Date.

     (b) Borrower  hereby  agrees to pay to the Agents for their own  respective
accounts,  the fees  agreed to by  Borrower  and the Agents  pursuant  to a side
letter agreement with each Agent.

                                   ARTICLE III

                                    PAYMENTS

     Section 3.1    Method of Payment.  
                    ------------------

     All  payments  of  principal,  interest,  and other  amounts  to be paid by
Borrower under this Agreement and the other Loan Documents  shall be paid to the
Administrative  Agent at the  Principal  Office for the  account of each  Bank's
Applicable Lending Office in Dollars and in immediately available funds, without
setoff,   deduction,   or  counterclaim,   not  later  than  1:00  p.m.  Boston,
Massachusetts time on the date on which such payment shall become due (each such
payment  made after such time on such due date to be deemed to have been made on
the next  succeeding  Business Day).  Borrower shall, at the time of making each
such payment,  specify to the Administrative  Agent the sums payable by Borrower
under this Agreement and the other Loan Documents to which such payment is to be
applied (and in the event that Borrower  fails to so specify,  or if an Event of
Default has occurred and is continuing,  the Administrative Agent may apply such
payment to the  Obligations in such order and manner as it may elect in its sole
discretion, subject to Section 3.4). Each payment received by the Administrative
Agent under this  Agreement or any other Loan Document for the account of a Bank
shall be paid promptly to such Bank, in  immediately  available  funds,  for the
account of such Bank's  Applicable  Lending  Office.  Whenever any payment under
this  Agreement  or any other Loan  Document  shall be stated to be due on a day
that is not a Business  Day,  such  payment  may be made on the next  succeeding
Business  Day, and such  extension of time shall in such case be included in the
computation of the payment of interest and commitment fee, as the case may be.

     Section 3.2    Optional Prepayment. 
                    -------------------- 

     Borrower  may,  upon at least three (3) Business  Days' prior notice to the
Administrative Agent, prepay the Notes in whole at any time or from time to time
in part  without  premium or penalty  but with  accrued  interest to the date of
prepayment  on the amount so  prepaid,  provided  that (a)  Eurodollar  Advances
prepaid  on a day  other  than  the  last day of the  Interest  Period  for such
Advances shall include the additional compensation,  if any, required by Section
4.5, and (b) each  partial  prepayment  shall be in the amount of the  aggregate
remaining  outstanding  principal  amount of the  Eurodollar  Advances or in the
principal amount of $1,000,000.00 or a greater integral  multiple  thereof.  All
notices  under this Section shall be  irrevocable  and must be given by Borrower
not later  than 11:00 a.m.  Boston,  Massachusetts  time on the day which is not
less than the number of Business Days specified above for such notice.  Optional
prepayments shall be applied to the Notes as set forth in Section 3.9.

     Section 3.3    Mandatory Prepayments.
                    ----------------------

     (a) Revolving Credit Notes.


                                       16

<PAGE>




     (i) Asset  Sales.  Immediately  upon the receipt of the  proceeds  thereof,
Borrower  shall prepay the Revolving  Credit Notes in an amount equal to the net
proceeds of any sale,  liquidation  or  disposition of any assets of any Company
(other than the Partnerships), where such net proceeds exceed $100,000.00.

     (ii)  Sale or  Issuance  of  Capital  Stock or Debt.  Immediately  upon the
receipt of the proceeds  thereof,  Borrower  shall prepay the  Revolving  Credit
Notes in an amount equal to fifty percent (50%) of any Issuance Proceeds.

     (iii) American  Physicians  Service Group.  Immediately upon the receipt of
the  proceeds of any  disposition  of the stock of American  Physicians  Service
Group,  Inc. held by any Company,  Borrower  shall prepay the  Revolving  Credit
Notes in an amount equal to excess of (A) the net  proceeds of any  disposition,
over (B) an amount equal to two dollars ($2.00) per share sold or disposed.

     (iv) Application of Mandatory  Prepayments.  Any such mandatory prepayments
of the Revolving  Credit Notes shall be applied to the Revolving Credit Notes on
a pro rata basis based upon the outstanding  principal balances of such Notes as
of the date of  payment.  Any such  prepayments  shall not reduce the  Revolving
Credit Commitments.

         (b)      Term Notes.
                  -----------
  
     (i)  Asset  Sales by  Partnerships.  Immediately  upon the  receipt  of the
proceeds thereof, Borrower shall prepay the Term Notes in an amount equal to the
net proceeds of any sale,  liquidation or  disposition of any  Partnership or of
any assets of any Partnership;  provided that such net proceeds shall be limited
to  Borrower's  or its  Wholly-Owned  Subsidiary's  pro rata portion of such net
proceeds; and provided further that Borrower shall not be required to prepay the
Term Notes to the  extent  that the net  proceeds  of any sale,  liquidation  or
disposition  of any assets of any  Partnership  are used by such  Partnership to
replace such assets with assets of similar  character within ninety (90) days of
such sale, liquidation or disposition.

     (ii)  Sale or  Issuance  of  Capital  Stock or Debt.  Immediately  upon the
receipt of the  proceeds  thereof,  Borrower  shall  prepay the Term Notes in an
amount equal to the lesser of (A) fifty percent (50%) of any Issuance  Proceeds,
and (B) the Applicable Payment Amount.

     (iii) Excess Cash Flow.  Borrower shall prepay the Term Notes within thirty
(30) days of the end of each fiscal  quarter of  Borrower,  commencing  with the
fiscal  quarter  ending on June 30,  1996,  in amount equal to the lesser of (A)
seventy-five  percent (75%) of Excess Cash Flow for such fiscal quarter, and (B)
the Applicable Payment Amount.

     (iv) Application of Mandatory Prepayments. Any mandatory prepayments of the
Term Notes shall be applied to the Term Notes on a pro rata basis based upon the
outstanding principal balances of such Notes as of the date of payment.

     Section 3.4    Pro Rata Treatment.
                    -------------------

     Except to the extent otherwise  provided herein:  (a) each Advance shall be
by the Banks under Section 2.1(a),  each payment of commitment fee under Section
2.8(a)  shall be made for the  account of the  Banks,  and each  termination  or
reduction of the Revolving Credit  Commitments under Section 2.1(c) or otherwise
shall be applied to the  Revolving  Credit  Commitments  of the Banks,  pro rata
according to the respective unused Revolving Credit Commitments;  (b) the making
and Continuation of Advances shall be made pro rata among the Banks according to
the amounts of their respective Commitments; and (c) each payment and prepayment
of  principal  of or  interest  on  Advances  by  Borrower  shall be made to the
Administrative  Agent for the account of the Banks in  accordance  with  Section
3.9.

     Section   3.5   Non-Receipt of Funds by the Administrative Agent.
                     ---------------------------------------------------  

     Unless  the  Administrative  Agent  shall have been  notified  by a Bank or
Borrower (the  "Payor")  prior to the date on which such Bank is to make payment
to the  Administrative  Agent of the  proceeds  of an  Advance  to be made by it
hereunder or Borrower is to make a payment to the  Administrative  Agent for the
account  of one or more of the  Banks,  as the case may be (such  payment  being
herein  called the  "Required  Payment"),  which notice shall be effective  upon
receipt,  that the Payor  does not  intend to make the  Required  Payment to the
Administrative

                                       17

<PAGE>




Agent,  the  Administrative  Agent may assume that the Required Payment has been
made and may, in reliance upon such  assumption  (but shall not be required to),
make the amount thereof available to the intended recipient on such date and, if
the Payor has not in fact made the Required Payment to the Administrative Agent,
the recipient of such payment  shall,  on demand,  return to the  Administrative
Agent the amount made available to it together with interest  thereon in respect
of the period  commencing  on the date such amount was so made  available by the
Administrative  Agent  until the date the  Administrative  Agent  recovers  such
amount at a rate per annum equal to the Federal Funds Rate for such period.

     Section 3.6    Withholding Taxes. 
                    ------------------

     All  payments by Borrower of  principal of and interest on the Advances and
of all fees and other  amounts  payable  under  any Loan  Document  are  payable
without  deduction for or on account of any present or future  taxes,  duties or
other  charges  levied or  imposed  by the  United  States of  America or by the
government  of any  jurisdiction  outside the United States of America or by any
political  subdivision or taxing authority of or in any of the foregoing through
withholding or deduction  with respect to any such payments.  If any such taxes,
duties or other charges are so levied or imposed,  Borrower will pay  additional
interest  or will make  additional  payments  in such  amounts so that every net
payment of principal  of and  interest on the Advances and of all other  amounts
payable by any of them under any Loan Document,  after  withholding or deduction
for or on account of any such present or future taxes,  duties or other charges,
will not be less than the amount  provided for herein or therein,  provided that
Borrower shall have no obligation to pay such additional  amounts to any Bank to
the extent that such taxes,  duties,  or other  charges are levied or imposed by
reason of the failure of such Bank to comply with the provisions of Section 3.7.
Borrower shall furnish promptly to the Administrative  Agent for distribution to
each affected Bank, as the case may be,  official  receipts  evidencing any such
withholding or reduction.

     Section 3.7    Withholding Tax Exemption.  
                    --------------------------

     Each Bank that is not  incorporated  under the laws of the United States of
America or a state  thereof  agrees  that it will  deliver to  Borrower  and the
Administrative  Agent two (2) duly  completed  copies of United States  Internal
Revenue  Service Form 1001 or 4224,  certifying in either case that such Bank is
entitled to receive  payments from  Borrower  under any Loan  Document,  without
deduction or withholding  of any United States  federal income taxes.  Each Bank
which so delivers a Form 1001 or 4224 further  undertakes to deliver to Borrower
and the  Administrative  Agent  two (2)  additional  copies  of such  form (or a
successor  form) on or before the date such form expires or becomes  obsolete or
after the occurrence of any event  requiring a change in the most recent form so
delivered by it, and such amendments  thereto or extensions or renewals  thereof
as may be reasonably requested by Borrower or the Administrative  Agent, in each
case  certifying  that such Bank is entitled to receive  payments  from Borrower
under any Loan Document  without  deduction or  withholding of any United States
federal income taxes,  unless an event (including  without limitation any change
in treaty,  law or regulation)  has occurred prior to the date on which any such
delivery would  otherwise be required which renders all such forms  inapplicable
or which would prevent such Bank from duly  completing  and  delivering any such
form with  respect to it and such Bank advises  Borrower and the  Administrative
Agent that it is not capable of receiving such payments without any deduction or
withholding of United States federal income tax.

     Section 3.8    Computation of Interest.  
                    ------------------------

     Interest  on the  Eurodollar  Advances  shall be computed on the basis of a
year of 360 days. Interest on Alternate Base Rate Advances and all other amounts
payable by Borrower hereunder shall be computed on the basis of a year of 365 or
366 days, as the case may be.

     Section 3.9    Order of Application.
                    ---------------------

     (a) No  Default.  Prior  to the  occurrence  of an Event  of  Default,  any
voluntary payment may (except as otherwise  provided herein) be applied,  at the
option of Borrower, to either the Revolving Notes or the Term Notes. Any payment
(whether  voluntary or mandatory) of the Revolving Notes shall be applied to the
Revolving  Notes on a pro  rata  basis  based  upon  the  outstanding  principal
balances of the  Revolving  Notes as of the date of payment.  Any payment of the
Term Notes (whether  voluntary or mandatory)  shall be applied to the Term Notes
on a pro rata basis based upon the  outstanding  principal  balances of the Term
Notes as of the date of payment, and (x) voluntary  prepayments shall be applied
to reduce the payments  required by Section 2.3(b) on a pro rata basis,  and (y)
mandatory  prepayments  shall be  applied  to reduce the  payments  required  by
Section 2.3(b) in the inverse order of maturity.


                                       18

<PAGE>




     (b) After Default.  After the  occurrence and during the  continuance of an
Event of Default, any payment shall be applied shall be applied in the following
order: (i) to all fees and expenses for which Agents or Banks have not been paid
or reimbursed in accordance with the Loan Documents (and if such payment is less
than all unpaid or  unreimbursed  fees and  expenses,  then the payment shall be
paid  against  unpaid  and  unreimbursed  fees  and  expenses  in the  order  of
incurrence or due date); (ii) to accrued interest on the Revolving Notes and the
Term Notes on a pro rata basis, based upon the outstanding principal balances of
such  Notes  as of the  date of  payment;  and  (iii)  to the  principal  of the
Revolving  Notes  and the  Term  Notes  on a pro  rata  basis,  based  upon  the
outstanding  principal balances of such Notes as of the date of payment, and any
such  prepayments  of the Term Notes  shall be  applied  to reduce the  payments
required  by  Section  2.3(b)  in such  order  as  shall  be  determined  by the
Administrative Agent in its sole discretion.

     (c)  Application to Advances.  Subject to the foregoing,  and so long as no
Event of Default has  occurred and is  continuing,  payments of principal of any
Note shall be applied  to such  outstanding  Alternate  Base Rate  Advances  and
Eurodollar Advances under such Note as Borrower shall select; provided, however,
that Borrower shall select Alternate Base Rate Advances and Eurodollar  Advances
to be repaid in a manner  designated to minimize the funding loss required to be
paid pursuant to Section 4.5, if any, resulting from such payment;  and provided
further that if Borrower  shall fail to select the Alternate  Base Rate Advances
and Eurodollar Advances to which such payments are to be applied, or if an Event
of Default has occurred and is continuing at the time of such payment,  then the
Administrative  Agent shall be entitled to apply the payment to such Advances in
the manner in which it shall deem appropriate in its sole discretion.

                                   ARTICLE IV

                         YIELD PROTECTION AND ILLEGALITY

     Section 4.1    Additional Costs.
                    -----------------

     (a) Borrower  hereby  agrees to pay directly to each Bank from time to time
such amounts as such Bank may determine to be necessary to compensate it for any
costs incurred by such Bank which such Bank  determines are  attributable to its
making or  maintaining  any Eurodollar  Advances  hereunder or its obligation to
make any of such Advances  hereunder,  or any reduction in any amount receivable
by such Bank hereunder in respect of any such Advances or such obligation  (such
increases in costs and  reductions  in amounts  receivable  being herein  called
"Additional Costs"), resulting from any Regulatory Change which:

     (i) changes the basis of taxation of any amounts payable to such Bank under
this  Agreement or its Notes in respect of any of such Advances  (other than (1)
taxes imposed on the overall net income of such Bank or its  Applicable  Lending
Office for any of such  Advances,  (2)  franchise or similar taxes of such Bank,
and (3) amounts withheld pursuant to the last sentence of Section 3.7);


     (ii) imposes or modifies any reserve,  special  deposit,  minimum  capital,
capital ratio,  or similar  requirement  relating to any extensions of credit or
other assets of, or any deposits with or other  liabilities or  commitments  of,
such Bank; or

     (iii) imposes any other  Additional  Cost  affecting  this Agreement or the
Notes or any of such extensions, of credit or liabilities or commitments.

     Each Bank will  notify  Borrower of any event  occurring  after the date of
this  Agreement  which will entitle such Bank to  compensation  pursuant to this
Section 4.1(a) as promptly as practicable after it obtains knowledge thereof and
determines  to  request  such  compensation,  and  will  designate  a  different
Applicable  Lending  Office  for the  Advances  affected  by such  event if such
designation will avoid the need for, or reduce the amount of, such  compensation
and will not,  in the sole  opinion  of such Bank,  violate  any law,  rule,  or
regulation  or be in any way  disadvantageous  to such Bank,  provided that such
Bank shall have no  obligation  to so designate  an  Applicable  Lending  Office
located outside the United States of America. Each Bank will furnish

                                       19

<PAGE>




Borrower  with a  certificate  setting  forth the  basis and the  amount of each
request of such Bank for  compensation  under this Section  4.1(a).  If any Bank
requests compensation from Borrower under this Section 4.1(a),  Borrower may, by
notice  to such  Bank  (with a copy to the  Administrative  Agent)  suspend  the
obligation of such Bank to make or Continue making Eurodollar Advances until the
Regulatory  Change giving rise to such request  ceases to be in effect (in which
case such Bank's  Eurodollar  Advances shall be Converted to Alternate Base Rate
Advances in accordance with the provisions of Section 4.4).

     (b) Without limiting the effect of the foregoing provisions of this Section
4.1, in the event that, by reason of any Regulatory  Change, any Bank either (i)
incurs  Additional  Costs based on or  measured by the excess  above a specified
level of the amount of a category of deposits or other  liabilities of such Bank
which  includes  deposits by reference to which the interest  rate on Eurodollar
Advances is determined as provided in this Agreement or a category of extensions
of credit or other  assets of such Bank which  includes  Eurodollar  Advances or
(ii)  becomes  subject  to  restrictions  on the  amount of such a  category  of
liabilities or assets which it may hold,  then, if such Bank so elects by notice
to Borrower (with a copy to the  Administrative  Agent),  the obligation of such
Bank to make or Continue making Eurodollar Advances hereunder shall be suspended
until such  Regulatory  Change ceases to be in effect (in which case such Bank's
Eurodollar  Advances  shall be  Converted  to  Alternate  Base Rate  Advances in
accordance with the provisions of Section 4.4).

     (c) Determinations and allocations by any Bank for purposes of this Section
4.1 of the  effect of any  Regulatory  Change on its  costs of  maintaining  its
obligations to make Advances or of making or maintaining  Advances or on amounts
receivable by it in respect of Advances,  and of the additional amounts required
to compensate such Bank in respect of any Additional Costs, shall be conclusive,
absent manifest error and provided that such  determinations and allocations are
made on a reasonable basis.

     Section 4.2    Limitation  on  Eurodollar  Advances.  
                    -------------------------------------

     Anything  herein to the  contrary  notwithstanding,  if with respect to any
Eurodollar Advance for any Interest Period therefor:

     (a) The  Administrative  Agent  determines  (which  determination  shall be
conclusive  absent  manifest  error) that  quotations of interest  rates for the
relevant  deposits referred to in the definition of "Eurodollar Rate" in Section
1.1  are  not  being  provided  in the  relative  amounts  or for  the  relative
maturities for purposes of determining the rate of interest for such Advances as
provided in this Agreement; or

     (b) The Required Banks determine (which  determination  shall be conclusive
absent  manifest  error) and notify  the  Administrative  Agent that the rate of
interest  referred to in the definition of  "Eurodollar  Rate" in Section 1.1 on
the basis of which the rate of  interest  for such  Advances  for such  Interest
Period is to be  determined do not  accurately  reflect the cost to the Banks of
making or maintaining such Advances for such Interest Period;

     then the  Administrative  Agent shall give Borrower  prompt notice  thereof
specifying  the  relevant  amounts  or  periods,  and so long as such  condition
remains in effect,  the Banks shall be under no  obligation  to make or Continue
additional  Eurodollar  Advances and Borrower  shall,  on the last day(s) of the
then-current Interest Period(s) for the outstanding Eurodollar Advances,  prepay
such  Eurodollar  Advances or Convert  them to Alternate  Base Rate  Advances in
accordance with Section 4.4.

     Section  4.3   Illegality.  
                    -----------

     Notwithstanding any other provision of this Agreement, in the event that it
becomes unlawful for any Bank or its Applicable  Lending Office to (a) honor its
obligation to make Eurodollar  Advances  hereunder,  or (b) maintain  Eurodollar
Advances  hereunder,  then such Bank shall promptly notify Borrower (with a copy
to the  Administrative  Agent)  thereof  and such Bank's  obligation  to make or
maintain Eurodollar Advances shall be suspended until such time as such Bank may
again  make  and  maintain  Eurodollar  Advances  (in  which  case  such  Bank's
Eurodollar  Advances  shall be  Converted  to  Alternate  Base Rate  Advances in
accordance with the provisions of Section 4.4).

     Section 4.4    Treatment of Eurodollar Advances. 
                    ---------------------------------

     If the  Eurodollar  Advances  of any Bank are to be  Converted  pursuant to
Section 4.1, 4.2 or 4.3, such Bank's Eurodollar  Advances shall be automatically
Converted  into  Alternate  Base Rate  Advances  on the last  day(s) of the then
current  Interest  Period(s) for the  Eurodollar  Advances (or, in the case of a
Conversion  required by Section  4.1(b) or 4.3(b),  on such earlier date as such
Bank may specify to Borrower with a copy to the

                                       20

<PAGE>




Administrative  Agent) and,  unless and until such Bank gives notice as provided
below that the  circumstances  specified  in Section  4.1, 4.2 or 4.3 which gave
rise to such Conversion no longer exist:

     (a) To the  extent  that  such  Bank's  Eurodollar  Advances  have  been so
Converted,  all payments and  prepayments of principal  which would otherwise be
applied to such  Bank's  Eurodollar  Advances  shall be  applied  instead to its
Alternate Base Rate Advances; and

     (b) All Advances which would otherwise be made or Continued by such Bank as
Eurodollar  Advances  shall be made as or  Converted  into  Alternate  Base Rate
Advances.

     If such Bank gives  notice to Borrower  (with a copy to the  Administrative
Agent) that the circumstances specified in Section 4.1, 4.2 or Section 4.3 which
gave rise to the Conversion of such Bank's Eurodollar  Advances pursuant to this
Section 4.4 no longer  exist  (which  such Bank agrees to do promptly  upon such
circumstances  ceasing to exist) at a time when Advances are  outstanding,  such
Bank's  Alternate Base Rate Advances shall be  automatically  Converted,  on the
first day(s) of the next  succeeding  Interest  Period(s)  for such  outstanding
Eurodollar  Advances  to the  extent  necessary  so that,  after  giving  effect
thereto, all Eurodollar Advances held by the Banks holding the same are held pro
rata (as to principal  amounts and Interest  Periods) in  accordance  with their
respective Commitments.

     Section 4.5    Compensation.  
                    -------------

     Borrower  shall pay to the  Administrative  Agent,  for the account of each
Bank,  upon the request of such Bank  through  the  Administrative  Agent,  such
amount or  amounts as shall be  sufficient  (in the  reasonable  opinion of such
Bank) to compensate it for any loss, cost, or expense incurred by it as a result
of:

     (a) Any payment,  prepayment or Conversion of a Eurodollar  Advance for any
reason  (including,  without  limitation,  the  acceleration  of the outstanding
Advances  pursuant  to  Section  11.2) on a date  other  than the last day of an
Interest Period for such Advance; or

     (b) Any failure by Borrower for any reason (including,  without limitation,
the failure of any conditions precedent specified in Article VI to be satisfied)
to borrow or  prepay a  Eurodollar  Advance  on the date for such  borrowing  or
prepayment,  specified in the relevant  notice of borrowing or prepayment  under
this Agreement.

     Such compensation shall not exceed the excess, if any, of (i) the amount of
interest which otherwise  would have accrued on the principal  amount so paid or
not  borrowed  for the period from the date of such payment or failure to borrow
to the last day of the  Interest  Period for such  Advance (or, in the case of a
failure  to  borrow,  the  Interest  Period for such  Advance  which  would have
commenced on the date specified for such  borrowing) at the  applicable  rate of
interest for such Advance  provided for herein over (ii) the interest  component
of the amount such Bank would have bid in the London interbank market for Dollar
deposits of leading banks and amounts  comparable to such  principal  amount and
with maturities comparable to such period.

     Section 4.6    Capital Adequacy. 
                    -----------------

     If after the date hereof,  any Bank shall have determined that the adoption
or implementation  of any applicable law, rule, or regulation  regarding capital
adequacy   (including,   without  limitation,   any  law,  rule,  or  regulation
implementing  the Basle  Accord),  or any change  therein,  or any change in the
interpretation  or   administration   thereof  by  any  central  bank  or  other
Governmental   Authority  charged  with  the  interpretation  or  administration
thereof, or compliance by such Bank (or its parent) with any guideline, request,
or directive regarding capital adequacy (whether or not having the force of law)
of  any  central  bank  or  other  Governmental  Authority  (including,  without
limitation,  any guideline or other requirement  implementing the Basle Accord),
has or would have the effect of  reducing  the rate of return on such Bank's (or
its  parent's)  capital as a  consequence  of its  obligations  hereunder or the
transactions  contemplated  hereby to a level below that which such Bank (or its
parent) could have  achieved but for such  adoption,  implementation,  change or
compliance  (taking  into  consideration  such Bank's  policies  with respect to
capital  adequacy) by an amount  deemed by such Bank to be  material,  then from
time to time,  within ten (10)  Business  Days after demand by such Bank (with a
copy to the Administrative  Agent), which demand shall be delivered by such Bank
to Borrower as promptly as practicable after such Bank obtains knowledge of such
reduction in its rate of return, Borrower shall pay to such Bank such additional
amount  or  amounts  as will  compensate  such  Bank  (or its  parent)  for such
reduction.  A certificate of such Bank claiming  compensation under this Section
and setting forth

                                       21

<PAGE>




the additional amount or amounts to be paid to it hereunder shall be conclusive,
absent manifest error and provided that the  determination  thereof is made on a
reasonable  basis. In determining such amount or amounts,  such Bank may use any
reasonable averaging and attribution methods.

                                    ARTICLE V

                                    SECURITY

     Section  5.1   Collateral.    
                    -----------

     To secure the full and complete payment and performance of the Obligations,
Borrower  shall  execute and deliver or cause to be executed and  delivered  the
documents described below covering the property and collateral described therein
(which,  together  with any  other  property  and  collateral  which  may now or
hereafter secure the Obligations or any part thereof, is sometimes herein called
the "Collateral"):

     (a) Borrower shall execute and deliver to the Administrative Agent, for the
benefit of the Banks, the Borrower Security Agreement.

     (b) The Guarantors shall execute and deliver to the  Administrative  Agent,
for the benefit of the Banks, the Guarantor Security Agreements.

     (c) Pledgors shall execute and deliver to the Administrative Agent, for the
benefit of the Banks, the Pledge Agreements.

     (d) Borrower shall execute and cause to be executed such further  documents
and instruments, including without limitation, Uniform Commercial Code financing
statements,  as the Administrative  Agent and the Documentation  Agent, in their
sole  discretion,  deem  necessary  or  desirable  to  evidence  and perfect the
Administrative Agent's liens and security interests in the Collateral.

     Section  5.2   Setoff.  
                    -------

     If an Event of Default shall have occurred and is continuing,  each Bank is
hereby authorized at any time and from time to time,  without notice to Borrower
(any such notice  being hereby  expressly  waived by  Borrower),  to set off and
apply any and all deposits (general or special,  time or demand,  provisional or
final) at any time held and other indebtedness at any time owing by such Bank to
or for  the  credit  or the  account  of  Borrower  against  any  and all of the
obligations  of Borrower now or hereafter  existing under this  Agreement,  such
Bank's Notes,  or any other Loan  Document,  irrespective  of whether or not the
Administrative  Agent or such  Bank  shall  have  made  any  demand  under  this
Agreement  or such Bank's Notes or such other Loan  Document  and although  such
obligations may be unmatured. Each Bank agrees promptly to notify Borrower (with
a copy to the  Administrative  Agent)  after any such  setoff  and  application,
provided  that the failure to give such notice  shall not affect the validity of
such setoff and application.  The rights and remedies of each Bank hereunder are
in addition to other rights and remedies (including,  without limitation,  other
rights of setoff) which such Bank may have.

     Section  5.3   Guaranties. 
                    -----------
       
     Each Guarantor shall  unconditionally and irrevocably guarantee the payment
and performance of the Obligations by execution and delivery of the Guaranties.

                                   ARTICLE VI

                              CONDITIONS PRECEDENT

     Section 6.1    Initial  Advance.  
                    -----------------

     The  obligation of each Bank to make its initial  Advance is subject to the
condition  precedent  that the  Documentation  Agent  shall have  received on or
before  the  day of  such  Advance  all of the  following,  each  dated  (unless
otherwise indicated) the date hereof, in form and substance  satisfactory to the
Documentation Agent:


                                       22

<PAGE>




     (a)  Resolutions.  Resolutions  of the Boards of  Directors of Borrower and
each Guarantor  certified by the Secretary or an Assistant  Secretary of each of
them which authorize the execution, delivery, and performance by such Company of
this Agreement and/or the other Loan Documents to which such Company is or is to
be a party;

     (b) Incumbency  Certificate.  A certificate of incumbency  certified by the
Secretary or an Assistant  Secretary of Borrower and each  Guarantor  certifying
the  names  of the  officers  of each  such  Company,  authorized  to sign  this
Agreement and each of the other Loan  Documents to which each such Company is or
is to be a party (including the certificates  contemplated herein) together with
specimen signatures of such officers;

     (c) Articles of  Incorporation.  The articles of  incorporation of Borrower
and each Guarantor certified, in the case of Borrower, by the Secretary of State
of  Delaware,  and,  in the  case  of each  Guarantor,  by the  Secretary  or an
Assistant Secretary of such Company;

     (d) Bylaws.  The bylaws of Borrower  and each  Guarantor  certified  by the
Secretary or an Assistant Secretary of each such Company;

     (e) Governmental  Certificates.  Certificates of the appropriate government
officials of the state of incorporation of Borrower and each Guarantor as to the
existence and good standing of each of them;

     (f) Notes. The Notes executed by Borrower;

     (g) Borrower Security  Agreement.  The Borrower Security Agreement executed
by Borrower;

     (h) Guaranties. The Guaranties executed by the Guarantors;

     (i)  Guarantor  Security  Agreement.   The  Guarantor  Security  Agreements
executed by the Guarantors;

     (j) Pledge Agreements. The Pledge Agreements executed by the Pledgors;

     (k) Financing  Statements.  Uniform  Commercial  Code financing  statements
executed by Borrower and each Guarantor and covering the Collateral;

     (l) Stock  Certificates.  Stock  certificates  evidencing all stock pledged
pursuant  to  the  Borrower  Security  Agreement  and  each  Guarantor  Security
Agreement, as applicable, together with stock powers duly executed in blank;

     (m) Certificates of Title.  Original  certificates of title,  together with
executed  applications  for title,  for all vehicles used in connection with the
transportation  of  lithotripters  pledged  pursuant  to the  Borrower  Security
Agreement and the Guarantor Security Agreements;

     (n)  Insurance  Policies.  Copies of all  insurance  policies  required  by
Section  8.5,   together   with  loss  payee   endorsements   in  favor  of  the
Administrative  Agent,  for  the  benefit  of the  Banks,  with  respect  to all
insurance policies covering Collateral;

     (o)  UCC and Tax  and  Judgment  Lien  Searches.  The  results  of  Uniform
Commercial Code searches showing all financing statements and other documents or
instruments,  and tax and judgment  lien  searches  showing all tax and judgment
liens, on file against each Company in such  jurisdictions as the Administrative
Agent shall  require,  such searches to be as of a date no more than twenty (20)
days prior to the date of the initial Advance;

     (p) Perfection Certificate. A Perfection Certificate,  in substantially the
form of Exhibit I hereto,  properly  completed and signed by the Chief Executive
or Chief Financial Officer of Borrower and the Guarantors;


                                       23

<PAGE>




     (q) Opinion of Counsel.  Favorable  opinions as to the matters set forth in
Exhibit J hereto of (i) Small,  Craig & Werkenthin,  special Texas legal counsel
to Borrower and the Guarantors,  (ii) Womble Carlyle  Sandridge & Rice,  special
North  Carolina  counsel  to  Litho,   (iii)  Bingham  Dana  &  Gould,   special
Massachusetts  legal  counsel to the Agents and the Banks,  and (iv) Moore & Van
Allen, L.L.C., special North Carolina counsel to the Agents and the Banks;

     (r)  Attorneys'  Fees and  Expenses.  Evidence  that the costs and expenses
(including attorneys' fees) referred to in Section 13.1, to the extent incurred,
shall have been paid in full by Borrower;

     (s) Fees. Borrower shall have paid to the Agents for their own account, the
fees owed by Borrower to the Agents  pursuant to the letter  agreements  of even
date herewith between Borrower and the Agents;

     (t)  Federal  Reserve  Board Form U-1.  For each Bank a properly  completed
Federal  Reserve Board Form U-1 duly executed by each Company  pledging stock of
another Company; and

     (u) Acquisition of Litho. Borrower shall have acquired good title, free and
clear of all Liens, to all of the issued and outstanding capital stock of Litho.

     Section 6.2    All Advances.  
                    -------------

     The  obligation  of each Bank to make any  Advance  (including  the initial
Advance) is subject to the following additional conditions precedent:

     (a) Advance Request Form. The Administrative Agent shall have received,  in
accordance  with Section 2.5, an Advance  Request Form executed by an authorized
officer of Borrower;

     (b) No Default. No Default shall have occurred and be continuing,  or would
result from such Advance;

     (c)  Representations  and  Warranties.   All  of  the  representations  and
warranties  contained  in  Article  VII  hereof  and in each of the  other  Loan
Documents  shall be true and correct on and as of the date of such  Advance with
the same force and effect as if such  representations  and  warranties  had been
made on and as of such date, except to the extent that such  representations and
warranties  speak to a specific date or the facts on which such  representations
and warranties are based have been changed by  transactions  contemplated by the
Loan Documents; and

     (d) Additional Documentation.  The Administrative Agent shall have received
such additional  approvals,  opinions, or documents as are required by the terms
and provisions of this Agreement or any other Loan Document.

                                   ARTICLE VII

                         REPRESENTATIONS AND WARRANTIES

     To induce the Agents and the Banks to enter into this  Agreement,  Borrower
hereby represents and warrants to the Agents and the Banks that:

     Section 7.1    Existence.
                    ----------

     (a)  Corporate   Existence.   Each  of  the   Companies   (other  than  the
Partnerships):  (a) is a corporation duly organized,  validly  existing,  and in
good standing under the laws of the jurisdiction of its  incorporation;  (b) has
all requisite  corporate  power and authority to own its assets and carry on its
business as now being or as proposed to be conducted; and (c) is qualified to do
business in all  jurisdictions  in which the nature of its  business  makes such
qualification  necessary  and where  failure to so qualify would have a material
adverse effect on the business, condition (financial or otherwise),  operations,
or  properties  of the  Companies  taken as a whole,  Borrower,  or any Material
Subsidiary.  Each  Company has the  corporate  power and  authority  to execute,
deliver,  and perform its  obligations  under this  Agreement and the other Loan
Documents to which it is or may become a party.

                                       24

<PAGE>




     (b)  Partnership  Existence.  Each of the  Partnerships:  (a) is a  general
partnership,  limited  partnership or limited liability company, as appropriate,
duly  organized,  validly  existing,  and in good standing under the laws of the
jurisdiction  of its  formation;  (b) has all  requisite  partnership  power and
authority or company power and authority, as appropriate,  to own its assets and
carry on its  business as now being or as proposed to be  conducted;  and (c) is
qualified  to do  business  in all  jurisdictions  in which  the  nature  of its
business  makes such  qualification  necessary  and where  failure to so qualify
would have a material  adverse effect on the business,  condition  (financial or
otherwise),  operations,  or  properties  of the  Companies  taken  as a  whole,
Borrower, or any Material Subsidiary.

     Section  7.2   Financial   Statements.   
                    -----------------------

     Borrower has delivered to the Administrative Agent (a) audited consolidated
financial  statements  of the  Companies  as of and for the  fiscal  year  ended
December 31, 1995, and unaudited  consolidated  financial statements of Borrower
for  the two  (2)  month  period  ended  February  29,  1996,  and  (b)  audited
consolidated  financial  statements of Litho and the  Partnerships as of and for
the fiscal years ended  December  31,  1995,  December 31, 1994 and December 31,
1993. Such financial  statements have been prepared in accordance with GAAP, and
fairly  present,  on a  consolidated  basis,  the  financial  condition  of  the
Companies and Litho and the Partnerships,  as appropriate,  as of the respective
dates indicated therein and the results of operations for the respective periods
indicated  therein.  There has been no material  adverse change in the business,
condition (financial or otherwise),  operations,  or properties of the Companies
taken as a whole,  Borrower, or any Material Subsidiary since the effective date
of the most recent financial statements referred to in this Section.

     Section 7.3    Corporate  Action:  No Breach.  
                    ------------------------------

     The execution,  delivery, and performance by each Company of this Agreement
and the other Loan  Documents to which such Company is or may become a party and
compliance  with the terms and  provisions  hereof  and  thereof  have been duly
authorized  by  all  requisite  corporate  action  (or,  if  such  Company  is a
partnership, then partnership action) on the part of such Company and do not and
will not (a) violate or conflict  with, or result in a breach of, or require any
consent under (i) the articles of  incorporation  or bylaws of such Company (or,
if such  Company  is a  partnership,  then  the  partnership  agreement  of such
Company),  (ii) any material applicable law, rule, or regulation or any material
order, writ, injunction,  or decree of any Governmental Authority or arbitrator,
or (iii) any material  agreement or  instrument to which such Company is a party
or by which such Company or any of its property is bound or subject  (other than
agreements  and  instruments  relating  to Debt  which will be paid off with the
proceeds of the initial Advance), or (b) constitute a material default under any
such agreement or instrument (other than agreements and instruments  relating to
Debt which will be paid off with the proceeds of the initial Advance), or result
in the creation or imposition of any Lien (except as provided in Article V) upon
any of the revenues or assets of any of the Companies.

     Section 7.4    Operation of Business.  
                    ----------------------

     Each of the Companies possesses all licenses, permits, franchises, patents,
copyrights,  trademarks, and tradenames, or rights thereto, necessary to conduct
their  respective  businesses  substantially  as now  conducted and as presently
proposed to be  conducted.  None of the  Companies  is in violation of any valid
rights of others with respect to any of the foregoing  (except where the failure
to do so would not have a material  adverse  effect on the  business,  condition
(financial or otherwise),  operations or properties of the Companies  taken as a
whole, Borrower, or any Material Subsidiary).

     Section 7.5    Litigation  and  Judgments.  
                    ---------------------------

     As of the date hereof, except as disclosed on Schedule 7.5 hereto, there is
no action,  suit,  investigation,  or proceeding  before or by any  Governmental
Authority or arbitrator  pending,  or to the  knowledge of Borrower,  threatened
against or affecting any of the Companies,  that would, if adversely determined,
have  a  material  adverse  effect  on the  business,  condition  (financial  or
otherwise),  operations  or  properties  of  the  Companies  taken  as a  whole,
Borrower,  or any  Material  Subsidiary  or the  ability of  Borrower to pay and
perform the Obligations. There are no outstanding judgments against any Company.

     Section 7.6    Rights in Properties; Liens. 
                    ----------------------------

     Each of the Companies has good and indefeasible title to or valid leasehold
interests in their respective material properties and assets, real and personal,
including  the  properties,  assets,  and leasehold  interests  reflected in the
financial  statements  described  in Section  7.2,  and none of the  properties,
assets, or leasehold  interests of any Company is subject to any Lien, except as
permitted by Section 9.2.


                                       25

<PAGE>




     Section 7.7    Enforceability.  
                    ---------------

     This Agreement constitutes,  and the other Loan Documents to which Borrower
is a party,  when  delivered,  shall  constitute the legal,  valid,  and binding
obligations of Borrower,  enforceable  against Borrower in accordance with their
respective terms, except as limited by bankruptcy,  insolvency, or other laws of
general  application  relating to the enforcement of creditors' rights. The Loan
Documents to which each Guarantor is a party,  when delivered,  shall constitute
the legal, valid, and binding obligations of such Guarantor, enforceable against
such Guarantor in accordance with their respective  terms,  except as limited by
bankruptcy,  insolvency,  or other laws of general  application  relating to the
enforcement of creditors' rights.

     Section 7.8    Approvals.  
                    ----------

     No  authorization,  approval,  or consent of, and no filing or registration
with, any Governmental  Authority or third party is or will be necessary for the
execution,  delivery,  or  performance  by  Borrower  or any  Guarantor  of this
Agreement and the other Loan  Documents to which Borrower or any Guarantor is or
may become a party or for the validity or enforceability thereof.

     Section 7.9    Debt. 
                    -----

     As of the date hereof,  the Companies have no Debt,  except as disclosed on
Schedule 7.9. 

     Section 7.10   Taxes.  
                    ------

     The Companies have filed or extended all tax returns  (federal,  state, and
local)  required  to be filed,  including  all  income,  franchise,  employment,
property,  and  sales  tax  returns,  and  have  paid  all of  their  respective
liabilities for taxes, assessments,  governmental charges, and other levies that
are due and payable.  Except as previously disclosed to the Administrative Agent
in writing, no Company knows of any pending  investigation of any of them by any
taxing authority or of any pending but unassessed tax liability of any of them.

     Section  7.11  Use of  Proceeds;  Margin  Securities.  
                    --------------------------------------

     No Company is engaged principally,  or as one of its important  activities,
in the business of extending  credit for the purpose of  purchasing  or carrying
margin stock  (within the meaning of  Regulations  G, T, U, or X of the Board of
Governors  of the Federal  Reserve  System),  and no part of the proceeds of any
Advance will be used to purchase or carry any margin  stock or to extend  credit
to others for the purpose of  purchasing or carrying  margin  stock,  except for
purchases of Borrower's capital stock permitted by Section 9.4 hereof.

     Section  7.12  ERISA.  
                    ------

     The  Companies  are  in  compliance  in  all  material  respects  with  all
applicable  provisions  of ERISA.  Neither a  Reportable  Event nor a Prohibited
Transaction  has occurred and is continuing  with respect to any Plan. No notice
of intent to terminate a Plan has been filed,  nor has any Plan been terminated.
No circumstances  exist which constitute grounds entitling the PBGC to institute
proceedings to terminate,  or appoint a trustee to  administer,  a Plan, nor has
the PBGC  instituted any such  proceedings.  None of the Companies nor any ERISA
Affiliate has completely or partially withdrawn from a Multi-employer  Plan. The
Companies and each ERISA Affiliate have met their minimum  funding  requirements
under ERISA with  respect to all of their  Plans,  and the present  value of all
vested  benefits  under each Plan does not exceed the fair  market  value of all
Plan  assets  allocable  to such  benefits,  as  determined  on the most  recent
valuation,  date of the Plan and in accordance with ERISA. None of the Companies
nor any ERISA Affiliate has incurred any liability to the PBGC under ERISA.

     Section  7.13  Disclosure.  
                    -----------

     All factual  information  (taken as a whole)  furnished  by or on behalf of
Borrower in writing to any Agent or any Bank (including, without limitation, all
factual  information  contained  in the Loan  Documents)  for  purposes of or in
connection  with this  Agreement,  the other Loan  Documents or any  transaction
contemplated herein or therein is, and all other such factual information (taken
as a whole) hereafter  furnished by or on behalf of Borrower in writing will be,
true and accurate in all material  respects on the date as of which such factual
information  is dated or  certified  and is not (and  such  factual  information
(taken as a whole)  hereafter  furnished  will not be) incomplete by omitting to
state any facts  necessary to make such factual  information  (taken as a whole)
not  misleading  in  any  material   respect  at  such  time  in  light  of  the
circumstances under which such factual information was provided.

     Section 7.14   Subsidiaries; Partnerships. 
                    ---------------------------

     Each of the Guarantors is a direct or indirect  wholly-owned  Subsidiary of
Borrower,  and as of the date hereof,  together with the Partnerships  listed on
Schedule 3, constitute all of the Subsidiaries of Borrower.  Schedule 7.14.1, as
the same may be amended from time to time to reflect  transactions  permitted by
this  Agreement,  sets forth the  outstanding  shares of capital stock (or other
ownership   interests)  and  the  name  of  each  shareholder  of  each  of  the
Subsidiaries of Borrower.  All of the outstanding  capital stock of Borrower and
each of its Subsidiaries has been validly issued,

                                       26

<PAGE>




is fully paid, and is nonassessable. Schedule 7.14.2, as the same may be amended
from time to time to reflect  transactions  permitted  by this  Agreement,  sets
forth the outstanding partnership interests of the Partnerships owned by each of
the Companies.

     Section 7.15   Agreements.  
                    -----------

     Except as set forth on Schedule  7.15,  none of the Companies is a party to
any indenture,  loan, or credit agreement, or to any lease or other agreement or
instrument,  or subject to any  charter or  corporate  restriction  which  could
reasonably  be  expected  to have a  material  adverse  effect on the  business,
condition  (financial or  otherwise),  operations or properties of the Companies
taken as a  whole,  Borrower,  or any  Material  Subsidiary  or the  ability  of
Borrower or any  Guarantor  to pay and perform  its  obligations  under the Loan
Documents  to which it is a party.  None of the  Companies  is in default in any
material  respect in the performance,  observance,  or fulfillment of any of the
obligations,  covenants,  or conditions contained in any agreement or instrument
to which it is a party,  which  default,  in the  aggregate  with all such other
defaults,  would  have a  material  adverse  affect on the  business,  condition
(financial or otherwise),  operations or properties of the Companies  taken as a
whole, Borrower, or any Material Subsidiary.

     Section 7.16   Compliance with Legal Requirements; Governmental
                    Authorizations.
                    -------------------------------------------------

     (a)  Except  as set  forth  in  Schedule  7.16.1:  (i) each  Company  is in
compliance in all material  respects with each Legal  Requirement that is or was
applicable to it or to the conduct or operation of its business or the ownership
or use of any of its  assets;  and (ii) no Company  has  received  any notice or
other communication from any Governmental Authority or other Person of any event
or  circumstance  which could  constitute  a violation  of, or failure to comply
with, any Legal Requirement.

     (b) Except as set forth in Schedule  7.16:  (i) each Company is in material
compliance  with  all  of  the  terms  and  requirements  of  each  Governmental
Authorization  held by such Company;  (ii) no Company has received any notice or
other  communication  from any  Governmental  Authority  or other Person of, any
event or  circumstance  which could  constitute  a  violation  of, or failure to
comply with, any term or requirement of any  Governmental  Authorization,  or of
any actual or potential revocation, withdrawal,  cancellation or termination of,
or  material  modification  to,  any  Governmental   Authorization;   (iii)  all
applications  required  to have  been  filed  for the  renewal  of any  required
Governmental  Authorizations  have been duly  filed on a timely  basis  with the
appropriate  Governmental  Authorities,  and all other filings  required to have
been made with respect to such Governmental  Authorizations  have been duly made
on a  timely  basis  with the  appropriate  Governmental  Authorities;  (iv) all
Governmental  Authorizations of the Companies are transferable to the Companies;
(v) upon  consummation of the transactions  contemplated  hereby,  the Companies
will lawfully hold all such Governmental  Authorizations;  and (vi) none of such
Governmental Authorizations will terminate upon consummation of the transactions
contemplated hereby. Except as set forth on Schedule 7.16, each of the Companies
possesses the necessary Governmental Authorizations (i) necessary to permit each
Company to lawfully conduct and operate its respective business in the manner it
currently  conducts and operates such business and to permit such Company to own
and use its  assets  in the  manner  in which it  currently  owns and uses  such
assets, and (ii) necessary to permit each Company,  upon the consummation of the
transactions  contemplated  hereby, to lawfully conduct and operate its business
and to permit each Company to own and use its assets,  where the failure to have
such  Governmental  Authorization  would have a material  adverse  effect on the
business,  condition  (financial or otherwise),  operations or properties of the
Companies taken as a whole, Borrower, or any Material Subsidiary.

     Section 7.17   Investment Company Act. 
                    -----------------------

     No Company is an "investment  company" within the meaning of the Investment
Company Act of 1940, as amended.

     Section 7.18   Public Utility  Holding  Company Act. 
                    --------------------------------------

     No Company is a "holding  company" or a "subsidiary  company" of a "holding
company" or an "affiliate" of a "holding  company" or a "public  utility" within
the meaning of the Public Utility Holding Company Act of 1935, as amended.

     Section 7.19   Environmental  Matters.  
                    -----------------------

     Except as disclosed on Schedule  7.19, as the same may be amended from time
to time, hereto:

     (a) Each of the Companies and all of their respective  properties,  assets,
and operations are in compliance in all material respects with all Environmental
Laws. No Company is aware of, nor have any of them received notice of, any past,

                                       27

<PAGE>




present, or future conditions, events, activities, practices, or incidents which
may  interfere  with or prevent the material  compliance  or continued  material
compliance of any Company with all material Environmental Laws; and

     (b)  The  Companies  have  obtained  all  material  permits,  licenses  and
authorizations  that are required under applicable  Environmental  Laws, and all
such  permits are in good  standing  and each  Company is in  compliance  is all
material respects with all of the terms and conditions of such permits.

     Section 7.20   Acquisition.  
                    -------------

     The Stock Purchase  Agreement  dated April 26, 1996,  executed by Borrower,
Litho,  and the Sellers defined therein  previously  delivered to the Agents and
the  Banks  is a true and  correct  copy of such  agreement,  and  Borrower  has
delivered to the Agents and the Banks true and correct copies of all amendments,
supplements and modifications  thereto.  Borrower has provided to the Agents and
the Banks all material information possessed by Borrower or of which Borrower is
aware regarding the acquisition by Borrower of the Acquisition of Litho.

                                  ARTICLE VIII

                               POSITIVE COVENANTS

     Borrower  hereby  covenants and agrees that, as long as the  Obligations or
any part  thereof  are  outstanding  or any Bank has any  Commitment  hereunder,
Borrower will perform and observe each of the following positive covenants:

     Section  8.1   Reporting   Requirements.   
                    -------------------------

     Borrower will furnish to the Administrative Agent and each Bank:

     (a) Annual  Financial  Statements.  As soon as available,  and in any event
within  ninety-five  (95) days after the end of each  fiscal  year of  Borrower,
beginning  with the fiscal year ending  December  31, 1996, a copy of the annual
audit report of the Companies for such fiscal year containing, on a consolidated
and  consolidating  basis,  balance  sheets and  statements of income,  retained
earnings,  and cash flow as at the end of such  fiscal  year and for the  twelve
(12)-month period then ended, in each case setting forth in comparative form the
figures for the preceding fiscal year,  audited by independent  certified public
accountants  of  recognized  standing,  and  accompanied  by an  opinion of such
independent  certified  public  accountants  stating  that such  report has been
prepared in accordance with GAAP;

     (b) Monthly Financial  Statements.  As soon as available,  and in any event
within  forty  (40) days  after  the end of each  month of each  fiscal  year of
Borrower, a copy of an unaudited financial report of the Companies as of the end
of such month and for the portion of the fiscal year then ended, containing,  on
a consolidated and consolidating  basis, balance sheets and statements of income
(together  with a  breakdown  of  revenues by  customer  and  procedure,  and of
expenses by procedure),  retained earnings,  and cash flow, in each case setting
forth in  comparative  form the  figures  for the  corresponding  period  of the
preceding fiscal year,  certified by the chief financial  officer of Borrower to
have been prepared in accordance with GAAP and to fairly and accurately  present
(subject to year-end audit  adjustments) the financial  condition and results of
operations of the Companies,  on a consolidated and consolidating  basis, at the
date and for the periods indicated therein;

     (c) Compliance  Certificate.  Concurrently with the delivery of each of the
financial  statements  referred to in Section  8.1(a) and within forty (40) days
after the end of each of the first three (3) fiscal quarters of each fiscal year
of Borrower,  a certificate of the chief executive or chief financial officer of
Borrower,  in  substantially  the form of  Exhibit K, (i)  stating  that to such
officer's knowledge, no Default has occurred and is continuing,  or if a Default
has occurred  and is  continuing,  a statement as to the nature  thereof and the
action that is proposed to be taken with  respect  thereto,  and (ii) showing in
reasonable detail the calculations demonstrating compliance with Article X;

     (d) Accounts Receivable Aging Report. As soon as available and in any event
within  forty  (40) days  after the end of each  month,  an aged  listing of the
accounts  receivable of each of Borrower and its  Subsidiaries  as of the end of
such month in a form reasonably satisfactory to the Administrative Agent;


                                       28

<PAGE>




     (e)  Business  Plan and Budget.  As soon as  available  and in any event by
December  15 of each year,  a copy of the annual  budget  and  business  plan of
Borrower and its  Subsidiaries  for the  upcoming  fiscal  year,  together  with
details of the assumptions, if any, underlying such budget and business plan;

     (f)  Management  Letters.  Promptly  upon  receipt  thereof,  a copy of any
management  letter or written  report  submitted  to any Company by  independent
certified public accountants with respect to the business,  condition (financial
or otherwise), operations, or properties of any Company;

     (g) Notice of Litigation.  Promptly after the commencement thereof,  notice
of all actions,  suits,  and proceedings  before any  Governmental  Authority or
arbitrator  affecting  Borrower or any of its Subsidiaries  which, if determined
adversely  to Borrower  or any such  Subsidiary,  could have a material  adverse
effect  on  the  business,  condition  (financial  or  otherwise),  options,  or
properties of Borrower, any Subsidiary or the Companies (taken as a whole);

     (h) Notice of Default. As soon as possible and in any event within five (5)
days after Borrower  knows of the  occurrence of each Default,  a written notice
setting forth the details of such Default and the action that Borrower has taken
and proposes to take with respect thereto;

     (i) ERISA Reports.  Promptly after the filing or receipt thereof, copies of
all reports,  including annual reports, and notices which any Company files with
or receives from the PBGC or the U.S.  Department  of Labor under ERISA;  and as
soon as possible and in any event  within five (5) days after any Company  knows
or has reason to know that any Reportable  Event or Prohibited  Transaction  has
occurred  with  respect  to any  Plan or  that  the  PBGC,  or any  Company  has
instituted or will  institute  proceedings  under Title IV of ERISA to terminate
any Plan, a certificate of the chief financial officer of Borrower setting forth
the  details  as to such  Reportable  Event or  Prohibited  Transaction  or Plan
termination and the action that Borrower proposes to take with respect thereto;

     (j) Reports to Other  Creditors.  Promptly  after the  furnishing  thereof,
copies  of  any  statement  or  report  furnished  by  Borrower  or  any  of its
Subsidiaries to any other creditor to which any Company owes $250,000.00 or more
pursuant to the terms of any indenture, loan, or credit or similar agreement and
not otherwise required to be furnished to the Administrative Agent and the Banks
pursuant to any other clause of this Section;

     (k)  Proxy  Statements,  Etc.  As soon as  available,  one (1) copy of each
financial statement,  report,  notice or proxy statement sent by Borrower to its
stockholders  generally  and one (1) copy of each  regular,  periodic or special
report,  registration  statement,  or  prospectus  filed  by  Borrower  with any
securities  exchange or the Securities and Exchange  Commission or any successor
agency including, without limitation, all Forms 10-K, 10-Q and 8-K and all other
periodic reports required to be filed under the Securities  Exchange Act of 1934
and the rules and regulations promulgated thereunder;

     (l) Partnership  Lists.  As soon as available,  and in any event (a) within
thirty (30) days after the end of each fiscal quarter of Borrower, a list of the
names of each partner of each of the Partnerships and as soon as available,  and
(b) within thirty (30) days after the date hereof and  thereafter  within thirty
(30) days after the end of each fiscal year of Borrower,  or upon the occurrence
and  during  the  continuance  of an Event of  Default,  a list of the names and
addresses of each partner of each of the Partnerships;

     (m)  Governmental  Authorizations.  Upon the request of the  Administrative
Agent, but not more often than one (1) time during each fiscal year of Borrower,
a complete and accurate list of each Governmental  Authorization held by each of
Companies or that  otherwise  relate to the business of, or to any of the assets
owned or used by, each of the Companies;

     (n) Litho and Partnership Statements.

     (i) As soon as  available,  and in any event within  thirty (30) days after
the date hereof,  unaudited  consolidated  financial statements of Litho and the
Partnerships for the three (3) month period ended March 31, 1996

                                       29

<PAGE>




and the four (4)  month  period  ended  April  30,  1996,  which  financial
statements  shall  not  reflect  a  material  adverse  change  in the  financial
condition  of Litho and the  Partnerships  since the  statements  referred to in
Section 7.2;

     (ii) As soon as  available,  and in any event within thirty (30) days after
the end of each fiscal  quarter of Borrower,  beginning  with the fiscal quarter
ended  September  30,  1996,  income  and cash flow  statements  for each of the
Partnerships on a consolidated and consolidating basis;

     (o) Partnership Actions.  Promptly after the incurrence thereof,  notice of
any Partnership's (i) incurrence of Debt, (ii) change in accounting treatment or
reporting  practices  (which change shall not affect any reporting  requirements
set  forth  herein  or the Loan  Documents),  except  as  permitted  by GAAP and
disclosed to the Administrative  Agent, (iii) change in tax reporting treatment,
except as  permitted by law,  (iv)  amendment  of any  partnership  agreement or
management  agreement between such Partnership and any Company and copies of any
such  amendment  certified  by an officer of Borrower as being true and correct,
and (v) change in its insurance; and

     (p)  General  Information.  Promptly,  such  other  information  concerning
Borrower or any of its Subsidiaries as the Administrative  Agent or any Bank may
from time to time reasonably request.

     Section 8.2    Maintenance of Existence; Conduct of Business.  
                    ----------------------------------------------

     Borrower will preserve and maintain its corporate  existence and all of its
leases, privileges,  licenses, permits, franchises,  qualifications,  and rights
that are  necessary  or  desirable  in the  ordinary  conduct  of its  business.
Borrower  will cause each of its  Subsidiaries  to  preserve  and  maintain  its
corporate,  partnership  or  other  similar  existence  and  all of its  leases,
privileges,  licenses, permits,  franchises,  qualifications and rights that are
necessary or desirable in the ordinary conduct of its business,  except, in each
case,  where  failure to do so would not have a material  adverse  effect on the
business,  condition  (financial or otherwise),  operations or properties of the
Companies taken as a whole, Borrower, or any Material Subsidiary.  Borrower will
conduct,  and will cause each of its Subsidiaries to conduct, its business in an
orderly and efficient manner in accordance with good business practices.

     Section 8.3    Maintenance of Properties.  
                    --------------------------

     Borrower  will  maintain,  keep,  and  preserve,  and  cause  each  of  its
Subsidiaries to maintain,  keep, and preserve,  all of its properties  (tangible
and  intangible)  necessary  or useful in the proper  conduct of its business in
good working order and condition,  except, in each case, as permitted by Section
9.8 or 9.9 or where  the  failure  to do so would  not have a  material  adverse
effect on the  business,  condition  (financial  or  otherwise),  operations  or
properties  of the  Companies  taken  as a  whole,  Borrower,  or  any  Material
Subsidiary.

     Section 8.4    Taxes and Claims.  
                    -----------------

     Borrower will pay or discharge,  and will cause each of its Subsidiaries to
pay or discharge,  at or before maturity or before  becoming  delinquent (a) all
material taxes, levies,  assessments,  and governmental charges imposed on it or
its income or  profits or any of its  material  property,  and (b) all  material
lawful claims for labor, material, and supplies,  which, if unpaid, might become
a Lien upon any of its  property;  provided,  however,  that no Company shall be
required to pay or discharge any tax, levy,  assessment,  or governmental charge
which is being  contested in good faith by  appropriate  proceedings  diligently
pursued, and for which adequate reserves have been established.

     Section 8.5    Insurance.  
                    ----------

     Borrower will maintain, and will cause each of its Subsidiaries to maintain
(except in the case of the  Partnerships,  in which case Borrower shall maintain
for the Partnerships),  insurance with financially sound and reputable insurance
companies  in such  amounts  and  covering  such risks as is usually  carried by
corporations  engaged in similar businesses and owning similar properties in the
same  general  areas  in which  the  Companies  operate,  consistent  with  past
practices  of  the  Companies  and  to  the  extent  available  on  commercially
reasonable  terms,  provided that in any event  Borrower will maintain and cause
each of its Subsidiaries (except in the case of the Partnerships,  in which case
Borrower shall maintain for the Partnerships) to maintain workmen's compensation
insurance,  property  insurance,   comprehensive  general  liability  insurance,
professional liability insurance, and business interruption insurance reasonably
satisfactory to the Banks. Each insurance policy covering  Collateral shall name
the  Administrative  Agent as loss payee,  for the benefit of the Banks,  as its
interests  may appear and shall provide that such policy will not be canceled or
reduced  without  thirty (30) days' prior written  notice to the  Administrative
Agent.  Borrower  will  annually  provide  the  Administrative  Agent  with  all
certificates  of insurance  evidencing all policies of insurance of Borrower and
its Subsidiaries.

                                       30

<PAGE>




     Section 8.6    Inspection Rights. 
                    ------------------

     At any  reasonable  time and from time to time after  reasonable  notice to
Borrower,  Borrower  will  permit,  and will cause each of its  Subsidiaries  to
permit,  representatives of the  Administrative  Agent and each Bank to examine,
copy,  and make  extracts  from its books and records,  to visit and inspect its
properties,  and to discuss its business,  operations,  and financial  condition
with its  officers,  and  independent  certified  public  accountants.  Prior to
removing any such copies or extracts from a Company's  premises,  such Company's
representatives  shall be  provided  a  reasonable  opportunity  to review  such
information  and  mark  or  identify  it  as   "confidential"  or  "confidential
information" as reasonably deemed appropriate by such Company.

     Section 8.7    Keeping Books and Records.  
                    --------------------------

     Borrower  will  maintain,  and  will  cause  each  of its  Subsidiaries  to
maintain,  proper books of record and account in which full,  true,  and correct
entries in conformity  with GAAP shall be made of all dealings and  transactions
in relation to its business and activities.

     Section 8.8    Compliance with Laws. 
                    ---------------------

     Borrower will comply, and will cause each of its Subsidiaries to comply, in
all material  respects with all material  applicable laws,  rules,  regulations,
orders, and decrees of any Governmental Authority or arbitrator.

     Section 8.9    Compliance  with  Agreements.  
                    -----------------------------                    

     Borrower will comply, and will cause each of its Subsidiaries to comply, in
all material respects with all agreements, contracts, and instruments binding on
it or affecting its  properties  or business,  except where the failure to do so
would not have a material adverse effect on the business,  condition  (financial
or  otherwise),  operations or  properties  of the  Companies  taken as a whole,
Borrower, or any Material Subsidiary.

     Section 8.10   Further Assurances.  
                    -------------------

     Borrower will (a), and will cause each of its Subsidiaries  (other than the
Partnerships)  to, execute and deliver such further  agreements and  instruments
and  take  such  further   action  as  may  be   reasonably   requested  by  the
Administrative  Agent to carry out the provisions and purposes of this Agreement
and the other Loan  Documents  and, (b) and will cause each of its  Subsidiaries
(including the Partnerships) to, create,  preserve, and perfect the Liens of the
Administrative Agent, for the benefit of the Banks, in the Collateral.

     Section 8.11   ERISA.  
                    ------

     Borrower will comply,  and will cause each of its  Subsidiaries  to comply,
with all minimum funding requirements,  and all other material requirements,  of
ERISA, if applicable, so as not to give rise to any liability thereunder.

     Section 8.12   Information Relating to Proposed  Acquisitions.  
                    -----------------------------------------------

     Borrower will use its best efforts to keep the Administrative Agent and the
Banks informed of the relevant information and status of and will share with the
Administrative Agent and the Banks and provide copies to the extent possible, of
all material due diligence information relating to any proposed Acquisition with
respect to which  Borrower or any  Subsidiary  enters into a letter of intent or
acquisition agreement, during the term of this Agreement.

     Section 8.13   After-Acquired Subsidiaries.  
                    ----------------------------

     Concurrently   upon  the  formation  or  Acquisition  by  Borrower  or  any
Subsidiary of any  Wholly-Owned  Subsidiary after the date hereof (pursuant to a
Permitted Acquisition or otherwise) (an "After-Acquired  Subsidiary"),  Borrower
shall cause the After-Acquired  Subsidiary to deliver articles of incorporation,
bylaws, and resolutions (or other corresponding  constituent documents) and such
opinions as the  Administrative  Agent shall  require and to execute a Guaranty,
Guarantor Security Agreement, and Pledge Agreement (if applicable),  as shall be
required by the Administrative  Agent to create first priority Liens in favor of
the Administrative  Agent, for the benefit of the Banks, in such  After-Acquired
Subsidiary's assets, to secure the Obligations.

     Section 8.14   Syndication Cooperation. 
                    ------------------------

     Borrower  acknowledges  that the Agents  intend  promptly  to  commence  to
syndicate  the  Commitments  of the Banks in accordance  with the  provisions of
Section 13.6.  Borrower agrees to actively assist Agents and their Affiliates in
achieving a  syndication  that is  satisfactory  to Agents and  Borrower  and in
preparing  information  requested by Agents in  connection  with  arranging  and
syndication of the Commitments of the Banks and to take such other action deemed
necessary  by Agents or their  Affiliates,  including  the  holding  of a formal
presentation  to  prospective  Banks to achieve a successful  syndication of the
Commitments by Agents. The syndication efforts will be accomplished by a variety
of means,

                                       31

<PAGE>




including the  preparation  of a confidential  information  memorandum and other
marketing  materials,  direct  contact  during the  syndication  between  senior
management  (including,  but not limited to, the chief  executive  officer,  the
chief  financial  officer and treasurer of Borrower) and advisors and Affiliates
of Borrower and the proposed syndicate Banks.

                                   ARTICLE IX

                               NEGATIVE COVENANTS

     Borrower  hereby  covenants and agrees that, as long as the  Obligations or
any part  thereof  are  outstanding  or any Bank has any  Commitment  hereunder,
Borrower will perform and observe the following negative covenants:

     Section 9.1    Debt.  
                    -----

     Borrower will not incur, create, assume, or permit to exist, nor permit any
of its Subsidiaries (other than the Partnerships) to incur,  create,  assume, or
permit to exist, any Debt, except:

     (a) Debt owed to the Agents and the Banks pursuant to the Loan Documents;

     (b) Existing Debt described on Schedule 7.9 hereto;

     (c) Debt owed to Borrower or to any Wholly-Owned Subsidiary;

     (d) Debt in an aggregate  principal amount not to exceed $250,000.00 at any
time  outstanding  the  proceeds of which are used by the  Companies to purchase
equipment, other than lithotripters;

     (e) Any Company's  obligations as general  partner of a Partnership for the
Debt of such Partnership; and

     (f) Any Company's Guarantee of Debt of any Partnership,  if such Company is
a general partner of such Partnership.

     Section 9.2    Limitation on Liens.  
                    --------------------

     Borrower will not incur, create, assume, or permit to exist, nor permit any
of its Subsidiaries (other than the Partnerships) to incur,  create,  assume, or
permit to exist, any Lien upon any of their respective  properties,  assets,  or
revenues, whether now owned or hereafter acquired, except:

     (a) Liens disclosed on Schedule 9.2;

     (b) Purchase money Liens securing Debt permitted by Section 9.1(d) and (e);

     (c) Liens in favor of the  Administrative  Agent,  for the  benefit  of the
Banks;

     (d) Encumbrances  consisting of minor easements,  zoning  restrictions,  or
other  restrictions on the use of real property that do not  (individually or in
the aggregate)  materially affect the value of the assets encumbered  thereby or
materially impair the ability of Borrower or any of its Subsidiaries to use such
assets in their  respective  businesses,  and none of which is  violated  in any
material respect by existing or proposed structures or land use;

     (e) Liens for taxes,  assessments,  or other governmental charges which are
not delinquent or which are being contested in good faith and for which adequate
reserves have been established;

     (f)  Liens of  mechanics,  materialmen,  warehousemen,  carriers,  or other
similar  statutory  Liens  securing  obligations  that  are  not yet due and are
incurred in the ordinary course of business; and

     (g) Liens  resulting  from  good  faith  deposits  to  secure  payments  of
workmen's  compensation  or other  social  security  programs  or to secure  the
performance of tenders,  statutory  obligations,  surety and appeal bonds, bids,
contracts  (other  than for  payment of Debt),  or leases  made in the  ordinary
course of business.

                                       32

<PAGE>




     Section 9.3    Mergers,  Etc.  
                    --------------

     Except upon the prior written consent of the Required Banks,  Borrower will
not become a party to a merger or  consolidation,  except with  another  Company
where Borrower is the surviving  entity.  Borrower will not, and will not permit
any of its Subsidiaries  (other than the Partnerships) to, wind-up,  dissolve or
liquidate  itself,  unless the assets and stock or other ownership  interests of
the Company being wound up,  dissolved or liquidated are  transferred to another
Company.  Except as permitted by Section  9.5,  Borrower  will not, and will not
permit  any of its  Subsidiaries  (other  than the  Partnerships)  to,  make any
Acquisition other than a Permitted Acquisition.  Borrower will not, and will not
permit  any  of  its  Subsidiaries  (other  than  the  Partnerships)  to,  form,
incorporate,  acquire or make any investment in any  Subsidiary,  except (a) the
Subsidiaries  listed on Schedule  7.14.1,  (b)  Subsidiaries  acquired or formed
through a Permitted  Acquisition,  and (c) Wholly-Owned  Subsidiaries  formed in
accordance with Section 8.13.

     Section 9.4    Restricted  Payments.  
                    ---------------------

     Borrower will not declare or pay any dividends or make any other payment or
distribution  (whether  in cash,  property,  or  obligations)  on account of its
capital stock,  or redeem,  purchase,  retire,  or otherwise  acquire any of its
capital  stock,  or permit any of its  Subsidiaries  to  purchase  or  otherwise
acquire any capital  stock of Borrower,  or set apart any money for a sinking or
other analogous fund for any dividend or other distribution on its capital stock
or for any redemption,  purchase, retirement, or other acquisition of any of its
capital  stock;  provided,  however,  that,  from the date  hereof  through  and
including  the  Termination  Date,  Borrower  may  redeem or retire  and/or  the
Companies  may  purchase  shares of  Borrower's  capital  stock for an aggregate
consideration of no more than $750,000.00.

     Section 9.5    Investments.  
                    ------------

     Borrower will not make, nor permit any of its Subsidiaries  (other than the
Partnerships)  to make,  any  advance,  loan,  extension  of credit,  or capital
contribution  to or  investment  in, or  purchase  or own,  or permit any of its
Subsidiaries (other than the Partnerships) to purchase or own, any stock, bonds,
notes, debentures, or other securities of, any Person, except:

     (a) The  Companies,  or any of them,  may purchase  (i) readily  marketable
direct  obligations  of the United States of America or any agency  thereof with
maturities of one year or less from the date of acquisition,  (ii) fully insured
certificates  of deposit  with  maturities  of one year or less from the date of
acquisition  issued by any  commercial  bank  operating in the United  States of
America  having  capital  and  surplus  in excess of  $1,000,000,000,  and (iii)
commercial  paper of a domestic  issuer if at the time of purchase such paper is
rated in one (1) of the two (2) highest rating categories of Standard and Poor's
Rating  Group,  a division of McGraw  Hill,  Inc.,  a New York  corporation,  or
Moody's Investors Service, Inc.;

     (b) The Companies,  or any of them,  may make loans to officers,  directors
and employees of any of them provided such loans are made in the ordinary course
of  business,  and  are  in an  aggregate  principal  amount  of not  more  than
$200,000.00 at any time outstanding;

     (c)  Borrower may  continue to hold  capital  stock of American  Physicians
Service Group, Inc. held by Borrower on the date hereof; and

     (d) The Companies may create new  Subsidiaries,  hold stock in Subsidiaries
and themselves,  and engage in the transactions permitted by Section 9.3 hereof,
provided that Borrower complies with Section 8.13.

     Section 9.6    Limitation on Issuance of Capital Stock.  
                    ----------------------------------------

     Borrower  will not permit  any of its  Subsidiaries  to at any time  issue,
sell,  assign,  or  otherwise  dispose of (a) any of its capital  stock or other
ownership interests,  (b) any securities exchangeable for or convertible into or
carrying  any  rights to acquire  any of its  capital  stock or other  ownership
interests,  or (c) any  option,  warrant,  or other  right to acquire any of its
capital  stock  or  other  ownership  interests;  provided,  however,  that  any
Subsidiary  of Borrower  may issue,  sell,  assign or  otherwise  dispose of its
capital stock or other ownership interests,  or securities  exchangeable for its
capital  stock  or  other  ownership   interests,   to  Borrower  or  any  other
Wholly-Owned Subsidiary.

     Section 9.7    Transactions With Affiliates. 
                    -----------------------------

     Borrower will not enter into,  and will not permit any of its  Subsidiaries
to enter into, any transaction,  including,  without  limitation,  the purchase,
sale,  or  exchange  of  property  or the  rendering  of any  service,  with any
Affiliate  of Borrower or any  Subsidiary  of  Borrower,  except in the ordinary
course of Borrower's or such

                                       33

<PAGE>




Subsidiary's  business and upon fair and  reasonable  terms no less favorable to
Borrower or such Subsidiary than would be obtained in a comparable  arm's-length
transaction with a Person not an Affiliate of Borrower or such Subsidiary.

     Section 9.8    Disposition of Assets.  
                    ----------------------

     Borrower will not sell, lease,  assign,  transfer,  or otherwise dispose of
any  of  its  assets,  nor  permit  any  of its  Subsidiaries  (other  than  the
Partnerships) to do so with any of their respective  assets,  except (subject to
the mandatory  prepayments required by Section 3.3) (a) inter-Company  transfers
between  Borrower  and  a  Wholly-Owned   Subsidiary  or  between   Wholly-Owned
Subsidiaries,  (b)  dispositions  of assets,  other than  lithotripters,  in the
ordinary course of business for  consideration  of up to an aggregate  amount of
$250,000.00  during the term of this Agreement,  (and the  Administrative  Agent
agrees  to  execute  and  deliver  releases  of Liens in  connection  with  such
dispositions), (c) dispositions by any Company of assets used in connection with
cardiac  rehabilitation  or  diagnostic  imaging,  and (d)  dispositions  of any
tangible  assets that are worn or obsolete,  provided that such tangible  assets
are replaced by assets of similar  character where the replacement of such asset
is necessary or appropriate for the continued conduct of such Company's business
as presently conducted.

     Section 9.9    Sale and Leaseback.  
                    -------------------

     Borrower  will not enter into,  nor permit any of its  Subsidiaries  (other
than the  Partnerships)  to enter into, any  arrangement  with any Person (other
than  another  Company)  pursuant to which it leases from such Person  equipment
used in lithotripsy  operations  that has been or is to be sold or  transferred,
directly  or  indirectly,  by it to such  Person;  provided,  however,  that the
Companies may enter into any  arrangement  with any Person  pursuant to which it
leases  from such  Person  real or  personal  property  not used in  lithotripsy
operations  that  has  been  or  is to  be  sold  or  transferred,  directly  or
indirectly,  by it to such Person,  in an  aggregate  amount of up to but not to
exceed $250,000.00 during the term of this Agreement.

     Section 9.10   Prepayment of Debt.  
                    -------------------

     Borrower will not prepay, nor permit any of its Subsidiaries to prepay, any
Debt, except the Obligations,  if such prepayment would result in Borrower being
in violation of Article X hereof.

     Section 9.11   Nature of Business. 
                    -------------------

     Borrower will not, and will not permit any of its Subsidiaries  (other than
the  Partnerships) to, engage in any business other than the businesses in which
they are engaged on the date hereof;  provided,  however, that Borrower will not
and will not permit any of its Subsidiaries  (other than the  Partnerships)  not
already in the business of providing non-medical  management services to cardiac
rehabilitation  or  diagnostic  imaging  operations,  to engage  in either  such
business.

     Section  9.12  Environmental Protection.  
                    -------------------------

     Borrower will not, and will not permit any of its  Subsidiaries to, conduct
any activity or use any of their  respective  properties or assets in any manner
that could reasonably be expected to violate any Environmental Law or create any
Environmental Liabilities for which Borrower or any of its Subsidiaries would be
responsible.

     Section 9.13   Accounting.  
                    -----------

     Borrower will not, and will not permit any of its Subsidiaries  (other than
the  Partnerships)  to,  change  its  fiscal  year or  make  any  change  (a) in
accounting  treatment  or reporting  practices,  except as permitted by GAAP and
disclosed to the Administrative Agent, or (b) in tax reporting treatment, except
as permitted by law.

     Section 9.14   Amendment of Partnership and Management Agreements.  
                    ---------------------------------------------------

     Borrower  will not, and will not permit any of its  Subsidiaries  to, amend
any  partnership  agreements  of  any  of the  Partnerships  or  any  management
agreements  between any Company and any of the  Partnerships,  if such amendment
could  reasonably be expected to have a material adverse effect on the business,
condition (financial or otherwise),  operations,  or properties of the Companies
taken as a whole, Borrower, or any Material Subsidiary.

                                    ARTICLE X

                               FINANCIAL COVENANTS

     Borrower  hereby  covenants and agrees that, as long as the  Obligations or
any part  thereof  are  outstanding  or any Bank has any  Commitment  hereunder,
Borrower will perform and observe the following financial covenants:


                                       34

<PAGE>




     Section 10.1   Total Debt to EBITDA.  
                    ---------------------

     Borrower will not permit the Total Debt to EBITDA  Ratio,  determined as of
the last day of each fiscal quarter of the Companies and for the four (4) fiscal
quarter  period then ending,  to exceed the ratio set forth opposite such period
below:


              Period                                             Ratio
              -------                                            -----
Date hereof through September 30, 1996                        4.00 to 1.0
October 1, 1996 through December 31, 1996                     3.25 to 1.0
January 1, 1997 through December 31, 1997                     3.00 to 1.0
January 1, 1998 through December 31, 1998                     2.50 to 1.0
January 1, 1999 and thereafter                                2.00 to 1.0

     For purposes of this Section 10.1, cash flows during the relevant period of
any entity acquired by the Companies during such period shall be included in the
calculation of EBITDA.

     Section 10.2   Interest Coverage Ratio. 
                    ------------------------

     Borrower  will not permit the Interest  Coverage  Ratio (a) as of September
30,  1996 for the six (6) month  period  then ended to be less than 2.75 to 1.0,
(b) as of December  31, 1996 for the nine (9) month period then ended to be less
than  3.25 to 1.0,  (c) as of the last day of March  31,  1997,  June 30,  1997,
September  30, 1997 and December 31, 1997,  in each case for the four (4) fiscal
quarters  then  ended,  to be less than  3.75 to 1.0,  (d) as of the last day of
March 31, 1998, June 30, 1998, September 30, 1998 and December 31, 1998, in each
case for the four (4) fiscal  quarters then ended,  to be less than 4.50 to 1.0,
and (e) as of the  last  day of each  fiscal  quarter  of  Borrower  thereafter,
commencing March 31, 1999, to be less than 5.25 to 1.0.

     Section 10.3   Total Debt Service Coverage Ratio.  
                    ----------------------------------

     Borrower  will not permit the Total Debt Service  Coverage  Ratio (a) as of
September  30, 1996 for the six (6) month period then ended to be less than 1.10
to 1.0,  (b) as of December 31, 1996 for the nine (9) month period then ended to
be less than 1.20 to 1.0,  and (c) as of the last day of each fiscal  quarter of
Borrower thereafter, commencing March 31, 1997, to be less than 1.30 to 1.0.

     Section 10.4   Consolidated Net Worth.  
                    -----------------------

     Borrower shall not permit, as of any date during the following periods, its
Consolidated Net Worth to be less than the amount set forth opposite such period
below, such amount to be (a) increased on the last day of each successive fiscal
quarter of Borrower, beginning June 30, 1996 to and including March 30, 1998, by
an amount  equal to one  hundred  percent  (100%) of the  increase  in net worth
arising from any Acquisition or equity  issuance,  and (b) increased on the last
day of each successive fiscal quarter of Borrower beginning June 30, 1998, by an
amount equal to seventy-five  percent (75%) of Consolidated  Net Income for such
fiscal quarter:


               Period                                             Amount
               ------                                             ------
Date hereof through September 29, 1996                        $55,000,000.00
September 30, 1996 through March 30, 1997                     $65,000,000.00
March 31, 1997 through September 29, 1997                     $70,000,000.00
September 30, 1997 through March 30, 1998                     $75,000,000.00
March 31, 1998 and thereafter                                 $75,000,000.00


                                       35

<PAGE>




     Section 10.5   Minimum  EBITDA.  
                    ----------------

     Borrower  will not permit (a) EBITDA for any one (1) fiscal  quarter of the
Companies  to be  less  than  $5,000,000.00,  or (b)  EBITDA  for  any  two  (2)
consecutive fiscal quarters of the Companies to be less than $12,000,000.00.

                                   ARTICLE XI

                                     DEFAULT

     Section 11.1   Events of Default.  
                    ------------------

     Each of the following shall be deemed an "Event of Default":

     (a) Borrower  shall fail to pay when due any amount of principal  under any
Note.

     (b)  Borrower  shall  fail to pay by the  Administrative  Agent or any Bank
(through the Administrative  Agent), any interest on the Advances,  any fees due
hereunder or under any other Loan Document, or any other part of the Obligations
which does not  constitute  principal  under the Notes,  and such failure  shall
continue for three (3) Business Days after such payment became due.

     (c) Any  representation  or warranty made or deemed made by Borrower or any
Obligated Party (or any of their respective officers) in any Loan Document or in
any certificate, report, notice, or financial statement furnished at any time in
connection with this Agreement shall be false,  misleading,  or erroneous in any
material  respect  when made or deemed to have been made and the effect  thereof
shall not have been cured within ten (10) Business Days after notice  thereof to
Borrower by the  Administrative  Agent or any Bank  (through the  Administrative
Agent).

     (d) Borrower shall fail to perform,  observe,  or comply with any covenant,
agreement,  or term  contained in Article X; or Borrower or any Obligated  Party
shall fail to perform,  observe, or comply with any covenant,  agreement or term
contained  in Section 8.1 (a),  (b),  (c) or (d), or Article IX and such failure
shall  continue for a period of three (3) Business Days after notice  thereof to
Borrower by the  Administrative  Agent or any Bank  (through the  Administrative
Agent);  or Borrower or any  Obligated  Party shall fail to perform,  observe br
comply with any other covenant,  agreement,  or term contained in this Agreement
or any other Loan Document  (other than  covenants to pay the  Obligations)  and
such failure shall  continue for a period of ten (10) Business Days after notice
thereof  to  Borrower  by the  Administrative  Agent  or any Bank  (through  the
Administrative Agent).

     (e) Any Company shall commence a voluntary  proceeding seeking liquidation,
reorganization,  or other  relief with  respect to itself or its debts under any
bankruptcy,  insolvency,  or other  similar  law now or  hereafter  in effect or
seeking the appointment of a trustee, receiver, liquidator,  custodian, or other
similar official of it or a substantial part of its property or shall consent to
any such  relief  or to the  appointment  of or  taking  possession  by any such
official in an  involuntary  case or other  proceeding  commenced  against it or
shall make a general  assignment for the benefit of creditors or shall generally
fail to pay its debts as they become due or shall take any  corporate  action to
authorize any of the foregoing.

     (f) An  involuntary  proceeding  shall be  commenced  against  any  Company
seeking liquidation,  reorganization,  or other relief with respect to it or its
debts under any bankruptcy, insolvency, or other similar law now or hereafter in
effect or seeking the appointment of a trustee, receiver, liquidator,  custodian
or other similar official for it or a substantial part of its property, and such
involuntary  proceeding  shall remain  undismissed  and unstayed for a period of
forty-five (45) days.

     (g) Any Company shall fail to discharge  within a period of forty-five (45)
days after the commencement  thereof any attachment,  sequestration,  or similar
proceeding or proceedings, including without limitation any order of forfeiture,
seizure or divestiture  (whether under RICO or otherwise) involving an aggregate
amount in excess of Two Hundred Fifty Thousand and 00/100 Dollars  ($250,000.00)
against any of its assets or properties.

     (h) A final judgment or judgments for the payment of money in excess of Two
Hundred Fifty Thousand and 00/100 Dollars  ($250,000.00)  in the aggregate shall
be rendered  by a court or courts  against any Company and the same shall not be
discharged  (or provision  shall not be made for such  discharge),  or a stay of
execution  thereof shall not be procured,  within  forty



                                       36

<PAGE>

- -five (45) days from the date of entry  thereof and such Company shall not,
within said period of  forty-five  (45) days, or such longer period during which
execution of the same shall have been  stayed,  appeal  therefrom  and cause the
execution thereof to be stayed during such appeal.

     (i) Any Company  shall fail to pay when due any principal of or interest on
Debt in an aggregate  principal  amount of Two Hundred Fifty Thousand and 00/100
Dollars  ($250,000.00) or more (other than the Obligations),  or the maturity of
any such Debt  shall  have been  accelerated,  or any such Debt  shall have been
required to be prepaid prior to the stated maturity thereof,  or any event shall
have  occurred  that permits (or, with the giving of notice or the lapse of time
or both,  would  permit) any holder or holders of such Debt or any Person acting
on behalf of such  holder or  holders  to  accelerate  the  maturity  thereof or
require any such prepayment.

     (j) This  Agreement  or any other Loan  Document  shall cease to be in full
force  and  effect  or  shall be  declared  null  and  void or the  validity  or
enforceability  thereof  shall be  contested  or  challenged  by  Borrower,  any
Subsidiary  of  Borrower,  any  Obligated  Party  or  any  of  their  respective
shareholders,  or  Borrower  or any  Obligated  Party shall deny that it has any
further liability or obligation under any of the Loan Documents,  or any Lien or
security interest created by the Loan Documents shall for any reason cease to be
a valid,  first priority perfected security interest in and Lien upon any of the
Collateral purported to be covered thereby.

     (k) Any of the  following  events  shall  occur or exist  with  respect  to
Borrower or any ERISA Affiliate:  (i) any Prohibited  Transaction  involving any
Plan; (ii) any Reportable Event with respect to any Plan; (iii) the filing under
Section  4041 of  ERISA of a  notice  of  intent  to  terminate  any Plan or the
termination of any Plan;  (iv) any event or circumstance  that might  constitute
grounds entitling the PBGC to institute  proceedings under Section 4042 of ERISA
for the termination  of, or for the appointment of a trustee to administer,  any
Plan, or the institution by the PBGC of any such proceedings; or (v) complete or
partial  withdrawal  under  Section 4201 or 4204 of ERISA from a  Multi-employer
Plan or the  reorganization,  insolvency,  or termination of any  Multi-employer
Plan; and in each case above,  such event or condition,  together with all other
events or conditions,  if any, have subjected or could in the reasonable opinion
of the Required Banks subject Borrower, or any of its Subsidiaries,  to any tax,
penalty,  or other  liability to a Plan, a  Multi-employer  Plan,  the PBGC,  or
otherwise (or any  combination  thereof) which in the aggregate  exceed or could
reasonably be expected to exceed Two Hundred Fifty  Thousand and 00/100  Dollars
($250,000.00).

     (l) Any Change in Control shall occur.

     (m) Borrower  shall fail to deliver to the  Administrative  Agent,  for the
benefit of the Banks,  interest rate hedging or other  protection  agreements (a
"Hedging  Agreement") with a Bank or other person  reasonably  acceptable to the
Agents in a  notional  amount of at least  Twenty  Million  and  00/100  Dollars
($20,000,000.00)  for a duration of at least three (3) years,  assuring that the
net  interest  cost on such  amount is  fixed,  capped  or  hedged,  in form and
substance  acceptable to the Administrative Agent within ninety (90) days of the
date hereof.

     Section 11.2   Remedies.  
                    ---------

     If any Event of Default shall occur and be continuing,  the  Administrative
Agent may (and if directed by the Required  Banks,  shall) do any one or more of
the following:

     (a)  Acceleration.  Declare all  outstanding  principal  of and accrued and
unpaid  interest on the Notes and all other  obligations  of Borrower  under the
Loan Documents  immediately due and payable, and the same shall thereupon become
immediately due and payable,  without  notice,  demand,  presentment,  notice of
dishonor,  notice of acceleration,  notice of intent to accelerate,  protest, or
other  formalities  of any kind,  all of which are  hereby  expressly  waived by
Borrower;

     (b) Termination of Commitments. Terminate the Commitments without notice to
Borrower;

     (c) Judgment. Reduce any claim to judgment;


                                       37

<PAGE>




     (d)  Foreclosure.  Foreclose or  otherwise  enforce any Lien granted to the
Administrative  Agent for the benefit of itself and the Banks to secure  payment
and  performance  of the  Obligations  in accordance  with the terms of the Loan
Documents; and

     (e) Rights.  Exercise any and all rights and remedies  afforded by the laws
of the Commonwealth of Massachusetts  or any other  jurisdiction,  by any of the
Loan Documents, by equity, or otherwise; 

provided,  however,  that  upon the  occurrence  of an Event  of  Default  under
Subsection (e) or (f) of Section 11.1, the Commitments of all of the Banks shall
automatically terminate, and the outstanding principal of and accrued and unpaid
interest  on the Notes  and all other  obligations  of  Borrower  under the Loan
Documents  shall  thereupon  become  immediately due and payable without notice,
demand,  presentment,  notice of  dishonor,  notice of  acceleration,  notice of
intent to accelerate,  protest,  or other  formalities of any kind, all of which
are hereby expressly waived by Borrower.

     Section 11.3   Performance by the Administrative Agent.  
                    ----------------------------------------

     If Borrower  shall fail to perform any covenant or agreement in  accordance
with the terms of the Loan  Documents,  the  Administrative  Agent  may,  at the
direction of the Required Banks,  perform or attempt to perform such covenant or
agreement on behalf of Borrower.  In such event,  Borrower shall, at the request
of  the  Administrative   Agent,   promptly  pay  any  amount  expended  by  the
Administrative  Agent or the  Banks  in  connection  with  such  performance  or
attempted  performance  to the  Administrative  Agent at the  Principal  Office,
together with  interest  thereon at the Default Rate from and including the date
of such  expenditure to but excluding the date such expenditure is paid in full.
Notwithstanding  the  foregoing,   it  is  expressly  agreed  that  neither  the
Administrative Agent nor any Bank shall have any liability or responsibility for
the performance of any obligation of Borrower under this Agreement or any of the
other Loan Documents.

                                   ARTICLE XII

                            THE ADMINISTRATIVE AGENT

     Section 12.1   Appointment, Powers and Immunities.  
                    -----------------------------------

     In  order  to  expedite  the  various  transactions  contemplated  by  this
agreement,  the Banks hereby  irrevocably  appoint and authorize  FNBB to act as
their Administrative Agent hereunder and under each of the other Loan Documents.
FNBB  consents  to such  appointment  and  agrees to  perform  the duties of the
Administrative  Agent as specified  herein.  The Banks  authorize and direct the
Administrative Agent to take such action in their name and on their behalf under
the terms and  provisions of the Loan  Documents and to exercise such rights and
powers  thereunder  as  are  specifically   delegated  to  or  required  of  the
Administrative Agent for the Banks,  together with such rights and powers as are
reasonably  incidental  thereto.  The  Administrative  Agent is hereby expressly
authorized to act as the Administrative  Agent on behalf of itself and the other
Banks:

     (a) To  receive on behalf of each of the Banks any  payment  of  principal,
interest,  fees or other amounts paid  pursuant to this  Agreement and the Notes
and to distribute to each Bank its pro rata share of all payments so received as
provided in this Agreement;

     (b) To  receive  all  documents  and items to be  furnished  under the Loan
Documents;

     (c) To act as nominee  for and on behalf of the Banks in and under the Loan
Documents;

     (d) To arrange for the means  whereby the funds of the Banks are to be made
available to Borrower;

     (e) To distribute to the Banks information,  requests,  notices,  payments,
prepayments,  documents  and  other  items  received  from  Borrower,  the other
Obligated Parties, and other Persons;

     (f) To execute and deliver to Borrower,  the other Obligated  Parties,  and
other Persons, all requests, demands, approvals,  notices, and consents received
from the Banks;

                                       38

<PAGE>




     (g) To the extent permitted by the Loan Documents, to exercise on behalf of
each Bank all rights and remedies of the Banks upon the  occurrence of any Event
of Default;

     (h) To accept,  execute,  and deliver the Security  Agreement and any other
security documents as the secured party; and

     (i) To take such other actions as may be requested by the Required Banks.

     Neither  the  Administrative  Agent  nor any of its  Affiliates,  officers,
directors,  employees,  attorneys, or agents shall be liable to any Bank for any
action  taken or omitted to be taken by any of them  hereunder  or  otherwise in
connection with this Agreement or any of the other Loan Documents (INCLUDING ANY
ACTION TAKEN OR OMITTED TO BE TAKEN BY SUCH PARTIES NEGLIGENTLY),  but excluding
such actions or omissions  arising from such  parties' own gross  negligence  or
willful  misconduct.  Without limiting the generality of the preceding sentence,
the  Administrative  Agent:  (i) may treat  the payee of any Note as the  holder
thereof until the Administrative Agent receives written notice of the assignment
or  transfer  thereof  signed  by such  payee  and in form  satisfactory  to the
Administrative Agent; (ii) shall have no duties or responsibilities except those
expressly set forth in this  Agreement and the other Loan  Documents,  and shall
not by reason of this  Agreement  or any other  Loan  Document  be a trustee  or
fiduciary for any Bank;  (iii) shall not be required to initiate any  litigation
or collection  proceedings  hereunder or under any other Loan Document except to
the extent requested by the Required Banks; (iv) shall not be responsible to the
Banks for any recitals,  statements,  representations or warranties contained in
this Agreement or any other Loan Document,  or any certificate or other document
referred to or provided for in, or received by any of them under, this Agreement
or  any  other  Loan  Document,  or  for  the  value,  validity,  effectiveness,
enforceability,  or  sufficiency of this Agreement or any other Loan Document or
any other  document  referred  to or  provided  for herein or therein or for any
failure by any Person to perform any of its obligations hereunder or thereunder;
(v) may consult with legal counsel (including counsel for Borrower), independent
public accountants, and other experts selected by it and shall not be liable for
any action taken or omitted to be taken in good faith by it in  accordance  with
the advice of such  counsel,  accountants,  or experts;  and (vi) shall incur no
liability  under or in respect of any Loan  Document  by acting upon any notice,
consent,  certificate,  or other  instrument  or  writing  believed  by it to be
genuine and signed or sent by the proper party or parties. As to any matters not
expressly provided for by this Agreement,  the Administrative Agent shall in all
cases be fully protected in acting, or in refraining from acting,  here under in
accordance with instructions signed by the Required Banks, and such instructions
of the Required  Banks and any action  taken or failure to act pursuant  thereto
shall be binding on all of the Banks; provided, however, that the Administrative
Agent shall not be required to take any action which exposes the  Administrative
Agent to personal  liability or which is contrary to this Agreement or any other
Loan Document or applicable law.

     Section 12.2   Rights of Administrative Agent as a Bank. 
                    -----------------------------------------

     With respect to its Commitment, the Advances made by it and the Note issued
to it, FNBB in its capacity as a Bank  hereunder  shall have the same rights and
powers  hereunder  as any other Bank and may exercise the same as though it were
not acting as the  Administrative  Agent,  and the term "Bank" or "Banks" shall,
unless the context otherwise indicates,  include the Administrative Agent in its
individual  capacity.  The Administrative  Agent and its Affiliates may (without
having to account therefor to any Bank) accept deposits from, lend money to, act
as trustee  under  indentures  of,  provide  merchant  banking  services to, and
generally  engage in any kind of  business  with  Borrower,  any  Subsidiary  of
Borrower,  any other Obligated  Party,  and any other Person who may do business
with or own securities of Borrower or any other  Obligated  Party,  all as if it
were not  acting as the  Administrative  Agent and  without  any duty to account
therefor to the Banks.

     Section 12.3   Sharing of Payments, Etc. 
                    -------------------------

     If any Bank shall obtain any payment of any principal of or interest on any
Advance made by it under this Agreement or payment of any other obligation under
the Loan  Documents then owed by Borrower or any other  Obligated  Party to such
Bank,  whether  voluntary,  involuntary,  through  the  exercise of any right of
setoff, banker's lien, counterclaim or similar right, or otherwise, in excess of
its pro rata  share,  such Bank shall  promptly  purchase  from the other  Banks
participations in the Advances held by them hereunder in such amounts,  and make
such other  adjustments  from time to time as shall be  necessary  to cause such
purchasing Bank to share the excess payment ratably with each of the other Banks
in accordance with its pro rata portion  thereof.  To such end, all of the Banks
shall  make  appropriate   adjustments   among  themselves  (by  the  resale  of
participations  sold or otherwise) if all or any portion of such excess  payment
is thereafter rescinded or must

                                       39

<PAGE>




otherwise be restored. Borrower agrees, to the fullest extent it may effectively
do so under  applicable law, that any Bank so purchasing a participation  in the
Advances  made by the other Banks may  exercise  all rights of setoff,  banker's
lien,  counterclaim,  or similar  rights with respect to such  participation  as
fully as if such Bank were a direct holder of Advances to Borrower in the amount
of such  participation.  Nothing  contained  herein  shall  require  any Bank to
exercise any such right or shall  affect the right of any Bank to exercise,  and
retain the  benefits  of  exercising,  any such right with  respect to any other
indebtedness or obligation of Borrower.

     Section 12.4   Indemnification.  
                    ----------------

     THE BANKS HEREBY AGREE TO INDEMNIFY THE ADMINISTRATIVE  AGENT FROM AND HOLD
THE  ADMINISTRATIVE  AGENT HARMLESS  AGAINST (TO THE EXTENT NOT REIMBURSED UNDER
SECTIONS 13.1 AND 13.2, BUT WITHOUT  LIMITING THE  OBLIGATIONS OF BORROWER UNDER
SECTIONS  13.1  AND  13.2),   RATABLY  IN  ACCORDANCE   WITH  THEIR   RESPECTIVE
COMMITMENTS, ANY AND ALL LIABILITIES,  OBLIGATIONS,  LOSSES, DAMAGES, PENALTIES,
ACTIONS, JUDGMENTS,  DEFICIENCIES,  SUITS, COSTS, EXPENSES (INCLUDING ATTORNEYS'
FEES), AND  DISBURSEMENTS OF ANY KIND OR NATURE  WHATSOEVER WHICH MAY BE IMPOSED
ON,  INCURRED  BY,  OR  ASSERTED  AGAINST  THE  ADMINISTRATIVE  AGENT IN ANY WAY
RELATING TO OR ARISING OUT OF ANY OF THE LOAN  DOCUMENTS  OR ANY ACTION TAKEN OR
OMITTED TO BE TAKEN BY THE  ADMINISTRATIVE  AGENT  UNDER OR IN RESPECT OF ANY OF
THE LOAN  DOCUMENTS  INCLUDING ANY PORTION OF THE FOREGOING TO THE EXTENT CAUSED
BY  THE  ADMINISTRATIVE  AGENT'S  SOLE  OR  CONTRIBUTORY  NEGLIGENCE;  PROVIDED,
FURTHER,  THAT NO BANK SHALL BE LIABLE FOR ANY PORTION OF THE  FOREGOING  TO THE
EXTENT  CAUSED  BY  THE  ADMINISTRATIVE  AGENT'S  GROSS  NEGLIGENCE  OR  WILLFUL
MISCONDUCT.  WITHOUT LIMITATION OF THE FOREGOING, IT IS THE EXPRESS INTENTION OF
THE BANKS THAT THE ADMINISTRATIVE AGENT SHALL BE INDEMNIFIED  HEREUNDER FROM AND
HELD HARMLESS AGAINST ALL OF SUCH  LIABILITIES,  OBLIGATIONS,  LOSSES,  DAMAGES,
PENALTIES, ACTIONS, JUDGMENTS,  DEFICIENCIES,  SUITS, COSTS, EXPENSES (INCLUDING
ATTORNEYS' FEES), AND DISBURSEMENTS OF ANY KIND OR NATURE DIRECTLY OR INDIRECTLY
ARISING OUT OF OR  RESULTING  FROM THE SOLE OR  CONTRIBUTORY  NEGLIGENCE  OF THE
ADMINISTRATIVE AGENT. WITHOUT LIMITING ANY OTHER PROVISION OF THIS SECTION, EACH
BANK AGREES TO REIMBURSE THE  ADMINISTRATIVE  AGENT PROMPTLY UPON DEMAND FOR ITS
PRO RATA  SHARE  (CALCULATED  ON THE  BASIS OF THE  COMMITMENTS)  OF ANY AND ALL
OUT-OF-POCKET   EXPENSES   (INCLUDING   ATTORNEYS'   FEES)   INCURRED   BY   THE
ADMINISTRATIVE  AGENT IN CONNECTION WITH THE PREPARATION,  EXECUTION,  DELIVERY,
ADMINISTRATION,   MODIFICATION,   AMENDMENT  OR  ENFORCEMENT   (WHETHER  THROUGH
NEGOTIATIONS, LEGAL PROCEEDINGS, OR OTHERWISE) OF, OR LEGAL ADVICE IN RESPECT OF
RIGHTS OR  RESPONSIBILITIES  UNDER,  THE LOAN DOCUMENTS,  TO THE EXTENT THAT THE
ADMINISTRATIVE AGENT IS NOT REIMBURSED FOR SUCH EXPENSES BY BORROWER.

     Section 12.5   Independent Credit Decisions.  
                    -----------------------------

     Each Bank agrees  that it has  independently  and  without  reliance on any
Agent or any other Bank, and based on such  documents and  information as it has
deemed  appropriate,  made its own credit  analysis of Borrower  and decision to
enter into this Agreement and that it will,  independently  and without reliance
upon any Agent or any other Bank, and based upon such documents and  information
as it shall deem appropriate at the time,  continue to make its own analysis and
decisions  in taking or not taking  action  under this  Agreement  or any of the
other Loan  Documents.  The  Administrative  Agent shall not be required to keep
itself informed as to the performance or observance by Borrower or any Obligated
Party of this  Agreement or any other Loan Document or to inspect the properties
or books of Borrower or any  Obligated  Party.  Except for notices,  reports and
other documents and information  expressly required to be furnished to the Banks
by the  Administrative  Agent hereunder or under the other Loan  Documents,  the
Administrative  Agent shall not have any duty or  responsibility  to provide any
Bank with any credit or other  financial  information  concerning  the  affairs,
financial  condition or business of Borrower or any  Obligated  Party (or any of
their Affiliates) which may come into the possession of the Administrative Agent
or any of its Affiliates.

     Section 12.6   Several Commitments.  
                    --------------------

     The Commitments and other obligations of the Banks under this Agreement are
several.  The  default by any Bank in making an Advance in  accordance  with its
Commitment shall not relieve the other Banks

                                       40

<PAGE>




of their  obligations  under this Agreement.  In the event of any default by any
Bank in making any Advance,  each  nondefaulting Bank shall be obligated to make
its  Advance  but  shall  not be  obligated  to  advance  the  amount  which the
defaulting Bank was required to advance hereunder. In no event shall any Bank be
required  to advance an amount or amounts  which shall in the  aggregate  exceed
such Bank's Commitment.  No Bank shall be responsible for any act or omission of
any other Bank.

     Section 12.7   Successor Administrative Agent. 
                    -------------------------------

     Subject to the  appointment  and  acceptance of a successor  Administrative
Agent as  provided  below,  the  Administrative  Agent may resign at any time by
giving notice thereof to the Banks and Borrower and the Administrative Agent may
be removed at any time with or without  cause by the  Required  Banks.  Upon any
such resignation or removal, the Required Banks will have the right to appoint a
successor  Administrative  Agent from among the remaining Banks. If no successor
Administrative  Agent shall have been so  appointed  by the  Required  Banks and
shall have accepted such appointment  within thirty (30) days after the retiring
Administrative  Agent's giving of notice of  resignation or the Required  Banks'
removal of the retiring  Administrative Agent, then the retiring  Administrative
Agent may,  on behalf of the Banks,  appoint a successor  Administrative  Agent,
which shall be a commercial  bank organized  under the laws of the United States
of America or any State  thereof and having  combined  capital and surplus of at
least  One  Billion  Dollars  ($1,000,000,000).   Upon  the  acceptance  of  its
appointment as successor  Administrative  Agent,  such successor  Administrative
Agent shall  thereupon  succeed to and become  vested  with all rights,  powers,
privileges,  immunities,  and duties of the resigning or removed  Administrative
Agent,  and the  resigning or removed  Administrative  Agent shall be discharged
from its  duties  and  obligations  under  this  Agreement  and the  other  Loan
Documents.   After  any  Administrative   Agent's   resignation  or  removal  as
Administrative  Agent,  the  provisions  of this  Article XII shall  continue in
effect for its benefit in respect of any actions taken or omitted to be taken by
it while it was the Administrative Agent.

     Section 12.8   Independent Contractor.
                    -----------------------

     (a) The relationship between each Agent and each of the Banks is that of an
independent contractor.  The use of the term "Agent" is for convenience only and
is used  to  describe,  as a form of  convention,  the  independent  contractual
relationship between each Agent and each of the Banks. Nothing contained in this
Agreement  or the other Loan  Documents  shall be construed to create an agency,
trust or other fiduciary relationship between any Agent and any of the Banks.

     (b) As an independent contractor empowered by the Banks to exercise certain
rights and perform certain duties and  responsibilities  hereunder and under the
other   Loan   Documents,   the   Administrative   Agent   is   nevertheless   a
"representative"  of the  Banks,  as that term is  defined  in  Article 1 of the
Uniform  Commercial  Code,  for purposes of actions for the benefit of the Banks
and the  Administrative  Agent  with  respect  to all  collateral  security  and
guaranties  contemplated  by  the  Loan  Documents.  Such  actions  include  the
designation of the Administration  Agent as "secured party,"  "mortgagee" or the
like on all financing  statements and other documents and  instruments,  whether
recorded or  otherwise,  relating  to the  attachment,  perfection,  priority or
enforcement of any security interests, mortgages or deeds of trust in collateral
security   intended  to  secure  the  payment  or  performance  of  any  of  the
Obligations, all for the benefit of the Banks and the Administrative Agent.

                                  ARTICLE XIII

                                  MISCELLANEOUS

     Section 13.1   Expenses.  
                    ---------

     Borrower  hereby  agrees to pay on  demand:  (a) all  reasonable  costs and
expenses  of  the  Agents  in  connection  with  the  preparation,  negotiation,
syndication,  execution,  and  delivery  of this  Agreement  and the other  Loan
Documents including,  without limitation, the legal fees and reasonable expenses
of legal counsel for the Agents;  (b) all  reasonable  costs and expenses of the
Agents  in  connection  with any and all  amendments,  modifications,  renewals,
extensions  and  supplements  of any of the Loan  Documents;  (c) all reasonable
costs and  expenses of the Agents and the Banks in  connection  with any Default
and the  enforcement of this  Agreement or any other Loan  Document,  including,
without  limitation,  the fees and expenses of legal  counsel for the Agents and
the  Banks;  (d) all  transfer,  stamp,  documentary,  or other  similar  taxes,
assessments,  or charges levied by any Governmental Authority in respect of this
Agreement  or any  of  the  other  Loan  Documents;  (e)  all  costs,  expenses,
assessments,   and  other  charges  incurred  in  connection  with  any  filing,
registration,  recording,  or  perfection  of  any  security  interest  or  Lien
contemplated by this Agreement or any other Loan Document; and (f) all other

                                       41

<PAGE>




reasonable  costs and expenses  incurred by the Agents in  connection  with this
Agreement or any other Loan Document,  including, without limitation, all costs,
expenses,  and other charges incurred in connection with obtaining any mortgagee
title insurance policy,  survey, audit,  appraisal in respect of the Collateral,
and other out-of-pocket costs and expenses.

     SECTION 13.2   INDEMNIFICATION.  
                    ----------------

     BORROWER  SHALL  INDEMNIFY  THE  AGENTS  AND EACH  BANK AND EACH  AFFILIATE
THEREOF AND THEIR RESPECTIVE  OFFICERS,  DIRECTORS,  EMPLOYEES,  ATTORNEYS,  AND
AGENTS  FROM,  AND  HOLD  EACH OF THEM  HARMLESS  AGAINST,  ANY AND ALL  LOSSES,
LIABILITIES,  CLAIMS, DAMAGES, PENALTIES, JUDGMENTS,  DISBURSEMENTS,  COSTS, AND
EXPENSES (INCLUDING  REASONABLE ATTORNEYS' FEES) TO WHICH ANY OF THEM MAY BECOME
SUBJECT  WHICH  DIRECTLY  OR  INDIRECTLY   ARISE  FROM  OR  RELATE  TO  (A)  THE
NEGOTIATION, EXECUTION, DELIVERY, PERFORMANCE, ADMINISTRATION, OR ENFORCEMENT OF
ANY OF THE LOAN DOCUMENTS, (B) ANY OF THE TRANSACTIONS  CONTEMPLATED BY THE LOAN
DOCUMENTS, (C) ANY BREACH BY BORROWER OF ANY REPRESENTATION, WARRANTY, COVENANT,
OR OTHER  AGREEMENT  CONTAINED IN ANY OF THE LOAN  DOCUMENTS,  (D) THE PRESENCE,
RELEASE,  THREATENED  RELEASE,  DISPOSAL,  REMOVAL,  OR CLEANUP OF ANY HAZARDOUS
MATERIAL LOCATED ON, ABOUT, WITHIN, OR AFFECTING ANY OF THE PROPERTIES OR ASSETS
OF BORROWER OR ANY SUBSIDIARY OF BORROWER, OR (E) ANY INVESTIGATION, LITIGATION,
OR   OTHER   PROCEEDING,   INCLUDING,   WITHOUT   LIMITATION,   ANY   THREATENED
INVESTIGATION, LITIGATION, OR OTHER PROCEEDING RELATING TO ANY OF THE FOREGOING.
WITHOUT  LIMITING  THE  FOREGOING,  THIS  INDEMNITY  SHALL  APPLY  TO ANY  LOSS,
LIABILITY,  OBLIGATION,  DAMAGE, PENALTY, JUDGMENT, CLAIM, DEFICIENCY OR EXPENSE
ARISING OUT OF THE SOLE OR CONCURRENT  NEGLIGENCE OF ANY AGENT OR ANY BANK,  BUT
SHALL EXCLUDE ANY LOSS, LIABILITY, OBLIGATION, DAMAGE, PENALTY, JUDGMENT, CLAIM,
DEFICIENCY  OR  EXPENSE  ARISING  BY REASON OF THE  GROSS  NEGLIGENCE  OR WILFUL
MISCONDUCT OF ANY AGENT OR BANK.

     Section 13.3   No Duty. 
                    --------

     All attorneys, accountants,  appraisers, and other professional Persons and
consultants  retained  by the Agents  and the Banks  shall have the right to act
exclusively  in the  interest of the Agents and the Banks and shall have no duty
of disclosure, duty of loyalty, duty of care, or other duty or obligation of any
type or nature whatsoever to Borrower, any shareholder or Subsidiary of Borrower
or any other Person.

     Section 13.4   No Fiduciary Relationship.  
                    --------------------------

     The  relationship  between  Borrower and each Bank is solely that of debtor
and  creditor,  and none of the Agents nor any of the Banks has any fiduciary or
other special relationship with Borrower, and no term or condition of any of the
Loan  Documents  shall  be  construed  so as to deem  the  relationship  between
Borrower and any Bank to be other than that of debtor and creditor.

     Section 13.5   No Waiver; Cumulative Remedies. 
                    -------------------------------

     No failure on the part of the Agents or any Bank to  exercise  and no delay
in exercising,  and no course of dealing with respect to, any right,  power,  or
privilege under this Agreement shall operate as a waiver thereof,  nor shall any
single or  partial  exercise  of any  right,  power,  or  privilege  under  this
Agreement  preclude any other or further exercise thereof or the exercise of any
other right,  power, or privilege.  The rights and remedies provided for in this
Agreement and the other Loan  Documents are  cumulative and not exclusive of any
rights and remedies provided by law.

     Section 13.6   Successors and Assigns.
                    -----------------------

     (a) This  Agreement  shall be binding  upon and inure to the benefit of the
parties hereto and their  respective  successors  and assigns.  Borrower may not
assign or transfer any of its rights or obligations  hereunder without the prior
written consent of the  Administrative  Agent and all of the Banks. Any Bank may
sell participations to one or more banks or other institutions in or to all or a
portion of its rights and  obligations  under this  Agreement and the other Loan
Documents  (including,  without limitation,  all or a portion of its Commitments
and  the  Advances  owing  to it);  provided,  however,  that  (i)  such  Bank's
obligations  under  this  Agreement  and the other  Loan  Documents  (including,
without  limitation,  its Commitments)  shall remain  unchanged,  (ii) such Bank
shall  remain  solely  responsible  to  Borrower  for  the  performance  of such
obligations,  (iii)  such  Bank  shall  remain  the  holder of its Notes for all
purposes of this  Agreement,  (iv)  Borrower  shall  continue to deal solely and
directly  with such Bank in connection  with such Bank's rights and  obligations
under this Agreement and the other Loan Documents, and

                                       42

<PAGE>




(v) such Bank shall not sell a participation that conveys to the participant the
right to vote or give or withhold  consents  under this  Agreement  or any other
Loan Document,  other than the right to vote upon or consent to (A) any increase
of such Bank's  Commitments,  (B) any reduction of the  principal  amount of, or
interest to be paid on, the  Advances  of such Bank,  (C) any  reduction  of any
commitment fee or other amount payable to such Bank under any Loan Document,  or
(D) any  postponement  of any date for the  payment  of any  amount  payable  in
respect of the Advances of such Bank.

     (b)  Borrower  and each of the  Banks  agree  that any Bank (an  "Assigning
Bank")  may at any time  assign  to one or more  Eligible  Assignees  all,  or a
portion of all, of its rights and obligations under this Agreement and the other
Loan  Documents  (including,  without  limitation,  its Commitment and Advances)
(each an  "Assignee");  provided,  however,  that (i)  except  in the case of an
assignment of all of a Bank's rights and  obligations  under this  Agreement and
the other Loan  Documents,  the amount of the  Commitments of the assigning Bank
being  assigned  pursuant to each  assignment  (determined as of the date of the
Assignment and Acceptance with respect to such assignment)  shall in no event be
less than  $5,000,000.00,  and (ii) the  parties to each such  assignment  shall
execute and deliver to the Administrative Agent for its acceptance and recording
in the Register (as defined below), an Assignment and Acceptance,  together with
the Note subject to such  assignment,  and a processing and  recordation  fee of
$3,000.00. Upon such execution,  delivery,  acceptance,  and recording, from and
after the effective date  specified in each  Assignment  and  Acceptance,  which
effective  date shall be at least  five (5)  Business  Days after the  execution
thereof,  or, if so specified in such  Assignment  and  Acceptance,  the date of
acceptance  thereof by the  Administrative  Agent,  (x) the assignee  thereunder
shall  be a party  hereto  as a  "Bank"  and,  to the  extent  that  rights  and
obligations  hereunder have been assigned to it pursuant to such  Assignment and
Acceptance,  have the rights and  obligations  of a Bank hereunder and under the
Loan  Documents and (y) the Bank that is an assignor  thereunder  shall,  to the
extent that rights and  obligations  hereunder have been assigned by it pursuant
to such  Assignment and  Acceptance,  relinquish its rights and be released from
its  obligations  under this Agreement and the other Loan Documents (and, in the
case of an Assignment and Acceptance  covering all or the remaining portion of a
Bank's rights and obligations under the Loan Documents, such Bank shall cease to
be a party thereto).

     (c) By executing and delivering an Assignment and Acceptance, the Assigning
Bank and its Assignee confirm to and agree with each other and the other parties
hereto as follows: (i) other than as provided in such Assignment and Acceptance,
such  Assigning  Bank  makes  no  representation  or  warranty  and  assumes  no
responsibility  with respect to any statements,  warranties,  or representations
made in or in connection  with the Loan  Documents or the  execution,  legality,
validity, and enforceability,  genuineness,  sufficiency,  or. value of the Loan
Documents or any other instrument or document furnished  pursuant thereto;  (ii)
such  Assigning  Bank  makes  no  representation  or  warranty  and  assumes  no
responsibility  with  respect to the  financial  condition  of  Borrower  or any
Obligated  Party or the  performance  or observance by Borrower or any Obligated
Party of its obligations  under the Loan Documents;  (iii) the Assignee confirms
that it has received copies of the Loan  Documents,  together with copies of the
financial  statements  referred to in Section 7.2 and such other  documents  and
information  as it has deemed  appropriate  to make its own credit  analysis and
decision to enter into such Assignment and  Acceptance;  (iv) the Assignee will,
independently  and  without  reliance  upon  the  Administrative  Agent  or such
assignor  and  based  on  such  documents  and  information  as  it  shall  deem
appropriate at the time,  continue to make its own credit decisions in taking or
not taking  action under this  Agreement and the other Loan  Documents;  (v) the
Assignee  confirms that it is an Eligible  Assignee;  (vi) the Assignee appoints
and authorizes the  Administrative  Agent to take such action as  Administrative
Agent on its behalf and  exercise  such powers  under the Loan  Documents as are
delegated to the Administrative  Agent by the terms thereof,  together with such
powers as are reasonably  incidental thereto; and (vii) the Assignee agrees that
it will perform in accordance with their terms all of the  obligations  which by
the terms of the Loan Documents are required to be performed by it as a Bank.

     (d) The Administrative  Agent shall maintain at its Principal Office a copy
of each Assignment and Acceptance delivered to and accepted by it and a register
for the  recordation  of the names and addresses of the Banks and the Commitment
of, and principal  amount of the Advances  owing to, each Bank from time to time
(the  "Register").  The entries in the Register  shall be conclusive and binding
for all purposes, absent manifest error, and Borrower, the Administrative Agent,
and the Banks may treat each Person  whose name is recorded in the Register as a
Bank hereunder for all purposes under the Loan Documents.  The Register shall be
available for inspection by Borrower or any Bank at any reasonable time and from
time to time upon reasonable prior notice.


                                       43

<PAGE>




     (e) Upon  its  receipt  of an  Assignment  and  Acceptance  executed  by an
assigning  Bank and Assignee  representing  that it is an Eligible  Assignee (or
other  assignee  permitted  hereunder),  together  with any Note subject to such
assignment,  the  Administrative  Agent shall, if such Assignment and Acceptance
has been  completed  and is in  substantially  the form of Exhibit A, (i) accept
such Assignment and Acceptance, (ii) record the information contained therein in
the Register,  and (iii) give prompt written notice thereof to Borrower.  Within
five (5)  Business  Days after its  receipt  of such  notice,  Borrower,  at its
expense,  shall execute and deliver to the Administrative  Agent in exchange for
the surrendered Note a new Note to the order of such Eligible Assignee (or other
assignee  permitted  hereunder)  in an  amount  equal  to  the  portion  of  the
Commitments assumed by it pursuant to such Assignment and Acceptance and, if the
Assigning  Bank has  retained  a portion of the  Commitments,  a new Note to the
order of the Assigning Bank in an amount equal to the portion of the Commitments
retained by it hereunder (each such  promissory  note shall  constitute a "Note"
for  purposes of the Loan  Documents).  Such new Notes shall be in an  aggregate
principal  amount of the surrendered  Note, shall be dated the effective date of
such Assignment and Acceptance, and shall otherwise be in substantially the form
of Exhibit B and Exhibit C.

     (f) Any Bank may, in connection  with any  assignment or  participation  or
proposed assignment or participation  pursuant to this Section,  disclose to the
Assignee or participant or proposed  Assignee or  participant,  any  information
relating to Borrower or any Subsidiary of Borrower furnished to such, Bank by or
on behalf of Borrower or any of its Subsidiaries.

     (g) Notwithstanding  any other term of this Agreement to the contrary,  any
Bank may (without  requesting the consent of either the Administrative  Agent or
Borrower)  pledge its Notes to a Federal  Reserve Bank in support of  borrowings
made by such Bank from such Federal Reserve Bank.

     (h) Notwithstanding  any other term of this Agreement to the contrary,  any
Bank may assign all, or a portion of all,  of its rights and  obligations  under
this Agreement and the other Loan Documents (including,  without limitation, its
Commitment  and  Advances)  to an  Affiliate  of such  Bank or any  other  Bank,
provided that:

     (i)  such   assignor   Bank  has  obtained  the  written   consent  of  the
Administrative  Agent  (which  consent  shall  not be  unreasonably  delayed  or
withheld) if the effect of such  assignment  or  delegation  shall  entitle such
Affiliate or other Bank to claim  compensation from Borrower pursuant to Article
IV; and

     (ii) in every other case,  such assignor Bank has furnished  notice to, but
not obtained the consent of, the Administrative Agent.

     Section 13.7   Survival.  
                    ---------

     All representations and warranties made in this Agreement or any other Loan
Document or in any document,  statement,  or certificate furnished in connection
with this  Agreement  shall survive the execution and delivery of this Agreement
and the other Loan Documents until the Obligations  have been paid and performed
in full, and no  investigation  by the  Administrative  Agent or any Bank or any
closing  shall affect the  representations  and  warranties  or the right of the
Administrative  Agent or any Bank to rely upon them.  Without  prejudice  to the
survival of any other  obligation  of Borrower  hereunder,  the  obligations  of
Borrower under Article IV and Sections 13.1 and 13.2 shall survive  repayment of
the  Notes  and  termination  of  the   Commitments.   The  obligations  of  the
Administrative  Agent and the Banks under Section 13.18 shall survive  repayment
of the Notes and termination of the Commitments.

     Section 13.8   ENTIRE  AGREEMENT.  
                    ------------------

     THIS AGREEMENT,  THE NOTES, AND THE OTHER LOAN DOCUMENTS REFERRED TO HEREIN
EMBODY THE FINAL,  ENTIRE  AGREEMENT  AMONG THE PARTIES HERETO AND SUPERSEDE ANY
AND ALL PRIOR  COMMITMENTS,  AGREEMENTS,  REPRESENTATIONS,  AND  UNDERSTANDINGS,
WHETHER  WRITTEN OR ORAL,  RELATING TO THE SUBJECT  MATTER HEREOF AND MAY NOT BE
CONTRADICTED OR VARIED BY EVIDENCE OF PRIOR, CONTEMPORANEOUS, OR SUBSEQUENT ORAL
AGREEMENTS OR DISCUSSIONS OF THE PARTIES  HERETO.  THERE ARE NO ORAL  AGREEMENTS
AMONG THE PARTIES HERETO.

     Section 13.9   Amendments, Etc. 
                    ----------------

     No amendment or waiver of any provision of this  Agreement,  the Notes,  or
any other Loan  Document to which  Borrower  is a party,  nor any consent to any
departure by Borrower therefrom, shall in any event

                                       44

<PAGE>




be  effective  unless the same shall be agreed or  consented  to by the Required
Banks and Borrower,  and each such waiver or consent shall be effective  only in
the specific  instance and for the specific  purpose for which given;  provided,
that no amendment, waiver, or consent shall, unless in writing and signed by all
of the Banks and Borrower, do any of the following:  (a) increase Commitments of
the Banks or subject  the Banks to any  additional  obligations;  (b) reduce the
principal of, or interest on, the Notes or any fees or other amounts  payable to
the Banks (but not the  Administrative  Agent) hereunder;  (c) postpone any date
fixed for any payment of principal  of, or interest on, the Notes or any fees or
other amounts payable to the  Administrative  Agent or the Banks hereunder;  (d)
change the percentage of the  Commitments or of the aggregate  unpaid  principal
amount of the Notes or the number of Banks which shall be required for the Banks
or any of them to take any action under this Agreement; (e) change any provision
contained  in this  Section  13.9;  or (f) release any  material  portion of the
Collateral,   except   in   accordance   with  the   relevant   Loan   Document.
Notwithstanding   anything  to  the  contrary  contained  in  this  Section,  no
amendment,  waiver, or consent shall be made with respect to Article XII without
the prior written consent of the Administrative Agent.

     Section 13.10  Maximum Interest Rate. 
                    ----------------------

     No provision of this  Agreement or of any other Loan Document shall require
the  payment or the  collection  of  interest  in excess of the  maximum  amount
permitted by applicable law. If any excess of interest in such respect is hereby
provided for, or shall be adjudicated to be so provided, in any Loan Document or
otherwise in  connection  with this loan  transaction,  the  provisions  of this
Section  shall  govern  and  prevail  and  neither  Borrower  nor the  sureties,
guarantors,  successors,  or assigns of Borrower  shall be  obligated to pay the
excess  amount  of such  interest  or any  other  excess  sum  paid for the use,
forbearance,  or detention of sums loaned pursuant hereto. In the event any Bank
ever receives,  collects, or applies as interest any such sum, such amount which
would be in excess of the maximum  amount  permitted by applicable  law shall be
applied  as a  payment  and  reduction  of the  principal  of  the  indebtedness
evidenced  by the Notes;  and,  if the  principal  of the Notes has been paid in
full, any remaining  excess shall forthwith be paid to Borrower.  In determining
whether or not the interest paid or payable  exceeds the Maximum Rate,  Borrower
and each Bank shall, to the extent permitted by applicable law, (a) characterize
any  non-principal  payment  as an  expense,  fee,  or  premium  rather  than as
interest,  (b) exclude  voluntary  prepayments and the effects thereof,  and (c)
amortize,  prorate,  allocate,  and spread in equal or  unequal  parts the total
amount of interest  throughout the entire  contemplated term of the indebtedness
evidenced by the Notes so that  interest for the entire term does not exceed the
Maximum Rate.

     Section 13.11  Notices. 
                    --------

     All notices and other communications provided for in this Agreement and the
other Loan  Documents  to which  Borrower  is a party  shall be given or made by
telecopy or in writing and  telecopied,  mailed by certified mail return receipt
requested,  or delivered to the intended  recipient at the "Address for Notices"
specified below its name on the signature pages hereof-,  or, as to any party at
such  other  address  as shall be  designated  by such party in a notice to each
other party given in accordance with this Section.  Except as otherwise provided
in this  Agreement,  all such  communications  shall be deemed to have been duly
given when  transmitted  by  telecopy,  subject  to  telephone  confirmation  of
receipt,  or when personally  delivered or, in the case of a mailed notice, when
duly  deposited  in the mails,  in each case given or  addressed  as  aforesaid;
provided,  however,  notices to the Administrative  Agent pursuant to Article II
shall not be effective until received by the Administrative Agent.

     Section 13.12  Governing  Law.  
                    ---------------

     This  Agreement  shall be governed by and construed in accordance  with the
laws of the Commonwealth of Massachusetts  and the applicable laws of the United
States of America.

     Section 13.13  Counterparts.  
                    -------------

     This Agreement may be executed in one or more  counterparts,  each of which
shall be deemed an original,  but all of which together shall constitute one and
the same instrument.

     Section 13.14  Severability. 
                    -------------

     Any provision of this Agreement  held by a court of competent  jurisdiction
to be invalid or  unenforceable  shall not impair or invalidate the remainder of
this Agreement and the effect thereof shall be confined to the provision held to
be invalid or illegal.

     Section 13.15  Headings.  
                    ---------

     The headings,  captions,  and  arrangements  used in this Agreement are for
convenience only and shall not affect the interpretation of this Agreement.


                                       45

<PAGE>




     Section 13.16  Construction.  
                    -------------

     Borrower, the Administrative Agent, and each Bank acknowledges that each of
them  has had the  benefit  of  legal  counsel  of its own  choice  and has been
afforded an  opportunity  to review this  Agreement and the other Loan Documents
with its legal counsel.

     Section 13.17  Independence of Covenants.  
                    --------------------------

     All  covenants  hereunder  shall be given  independent  effect so that if a
particular  action or condition is not permitted by any of such  covenants,  the
fact that it would be permitted by an exception  to, or be otherwise  within the
limitations of, another  covenant shall not avoid the occurrence of a Default if
such action is taken or such condition exists.

     Section 13.18  Confidentiality.
                    ----------------

     (a) The Agents and the Banks shall treat the  Confidential  Information  in
confidence and undertake the following obligations with respect thereto:

     (i) The Agents and each Bank and each Other Recipient (hereinafter defined)
shall  not  make  use of,  disseminate,  or in any  way  disclose,  directly  or
indirectly,  to any other  Person other than the senior  executives,  employees,
attorneys, accountants and examiners of the Agents and each Bank, who reasonably
require access to the  Confidential  Information  for the proper  performance of
their assigned duties,  and any  contemplated  assignee of all or a portion of a
Bank's rights and  obligations  under this Agreement  (collectively,  the "Other
Recipients")  any  Confidential  Information  without  receiving  prior  written
permission from Borrower. Each Other Recipient will be informed of the terms and
provisions of this Section  13.18,  and the Banks shall be liable for any breach
of any term or provision of this Section 13.18 by any Other Recipient as if such
person was a signatory  hereto,  unless such Other  Recipient has entered into a
confidentiality agreement directly with Borrower; and

     (ii) The  Agents  and each  Bank and each  Other  Recipient  shall  use the
Confidential  Information  solely in  connection  with the Loan  Documents or in
connection  with the  ordinary  course of  business  of the  Agents or the Banks
(except  if such  ordinary  course of  business  activities  are  adverse to the
Companies' interests) and shall not use any of such Confidential Information for
any other  purpose or aid any Person  (other  than the  Agents,  any Bank or any
Other  Recipient) in learning of or using it or permit others to learn of or use
it.

     (b) In the event that any Agent,  any Bank or any Other  Recipient  becomes
legally  compelled to disclose  any of the  Confidential  Information,  it shall
provide  Borrower with notice promptly after receiving  notice of any proceeding
relating to such disclosure so that the Companies may seek a protective order or
other  appropriate  remedy.  In the event  that such  protective  order or other
remedy is not obtained on or before the date that  disclosure must be made, such
Agent,  such Bank or the Other Recipient,  as the case may be, will furnish only
that portion of the  Confidential  Information  which it is legally  required to
disclose.

     (c) The  Agents  and the Banks  are  aware,  and agree to inform  all Other
Recipients,  that the United States  securities laws prohibit any Person who has
received material, non-public information such as is the subject of this Section
13.18 from an issuer from purchasing or selling the securities of such issuer or
from communicating  such information to any other Person under  circumstances in
which it is  reasonably  foreseeable  that such  Person is likely to purchase or
sell such securities.

     (d) The Companies and the Agents and the Banks agree that monetary  damages
would not be a  sufficient  remedy for any breach of this  Section  13.18 by the
Agents,  the Banks or any Other  Recipient  and that,  in  addition to all other
remedies, the Companies shall be entitled to specific performance and injunction
or other equitable relief as a remedy for any such breach.

     (e) The  restrictions  and  obligations of this Section 13.18 shall survive
the  repayment of the  Obligations  and shall  continue to bind the Agents,  the
Banks and the Other Recipients.


                                       46

<PAGE>




     Section 13.19  Renewal  and  Increase.  
                    -----------------------

     The  Revolving  Credit  Loan is in  renewal,  extension,  modification  and
amendment of the Original  Credit  Agreement and the loan documents  executed in
connection  therewith,  and all liens and security  interests  securing  payment
thereof.

     Section 13.20  WAIVER OF JURY TRIAL.  
                    ---------------------

     TO  THE  FULLEST  EXTENT  PERMITTED  BY  APPLICABLE  LAW,  BORROWER  HEREBY
IRREVOCABLY  AND  EXPRESSLY  WAIVES ALL RIGHT TO A TRIAL BY JURY IN ANY  ACTION,
PROCEEDING,  OR COUNTERCLAIM  (WHETHER BASED UPON CONTRACT,  TORT, OR OTHERWISE)
ARISING  OUT OF OR  RELATING TO ANY OF THE LOAN  DOCUMENTS  OR THE  TRANSACTIONS
CONTEMPLATED THEREBY OR THE ACTIONS OF ANY AGENT OR ANY BANK IN THE NEGOTIATION,
ADMINISTRATION, OR ENFORCEMENT THEREOF.

     Section 13.21  CHOICE OF FORUM; CONSENT TO SERVICE OF PROCESS AND
                    JURISDICTION.  
                    ---------------------------------------------------

     Any suit,  action or  proceeding  against  Borrower  with  respect  to this
Agreement or the Loan Documents, or any judgment entered by any court in respect
thereof,  may be  brought in the courts of the  Commonwealth  of  Massachusetts,
County of Suffolk, or in the United States courts located in the Commonwealth of
Massachusetts  as  the  Administrative  Agent  shall,  at the  direction  of the
Required Banks elect in their sole discretion,  and Borrower irrevocably submits
to the  non-exclusive  jurisdiction  of such courts for the purpose of any suit,
action or proceeding. Borrower irrevocably consents to the service of process in
any suit,  action or  proceeding  in said  court by the  mailing  thereof by the
Administrative  Agent by  registered  or  certified  mail,  postage  prepaid  to
Borrower's  address  shown  opposite  its name on the  signature  pages  hereof.
Nothing herein or in any of the other Loan  Documents  shall affect the right of
the  Administrative  Agent to serve process in any other manner permitted by law
or shall  limit the  right of the  Administrative  Agent to bring any  action or
proceeding  against Borrower or with respect to any of its property in courts in
other jurisdictions. Borrower irrevocably waives any objections which it may now
or hereafter have to laying of venue of any suit,  action or proceeding  arising
out of or relating to this Agreement or the other Loan Documents  brought in the
courts located in the  Commonwealth  of  Massachusetts,  County of Suffolk,  and
hereby  further  irrevocably  waives  any claim  that any such  suit,  action or
proceeding brought in any such court has been brought in any inconvenient forum.
Any action or proceeding  by Borrower  against the  Administrative  Agent or any
Bank shall be brought only in a court located in Suffolk County, Massachusetts.

                   [Balance of Page Intentionally Left Blank]

                                       47

<PAGE>




     IN WITNESS WHEREOF, the parties hereto have duly executed this Agreement as
of the day and year first above written.

                                                BORROWER:

                                                PRIME MEDICAL SERVICES, INC.

                                                By:
                                                     Cheryl Williams
                                                     Vice President - Finance

                                                Address for Notices:

                                               1301 Capital of Texas Highway
                                                  Suite C-300
                                               Austin, Texas 78746
                                               Attention: President

                                               Fax No.: (512) 328-8510
                                               Telephone No.: (512) 328-2892




                                       48

<PAGE>




                                  FNBB:

                                  THE FIRST NATIONAL BANK OF BOSTON,
                                  as Administration Agent, Syndication Agent, 
                                  and  a Bank

                                  By:
                                       Oscar C. Jazdowski
                                  Managing Director, High Technology
                                  Division, Medical Technology Group

                                  Address for Notices:

                                  100 Federal Street
                                  P.O. Box 2016
                                  Boston, Massachusetts 02100
                                  Attention: Oscar C. Jazdowski

                                  Fax No.: (617)  434-0819
                                  Telephone No.: (617)  434-2824

                                  Lending Office for Base Rate Advances:
                                  100 Federal Street
                                  P. 0. Box 2016
                                  Boston, Massachusetts 02100

                                  Lending Office for Eurodollar Advances:
                                  100 Federal Street
                                  P.O. Box 2016
                                  Boston, Massachusetts 02100




                                       49

<PAGE>




                                  NATIONSBANK:

                                  NATIONSBANK OF TEXAS, N.A.,
                                  as Documentation Agent and a Bank

                                  By:
                                  Cecil G. Edwards, Jr.
                                  Senior Vice President

                                  Address for Notices:
                                  901 Main Street, 7th Floor
                                  Post Office Box 831000
                                  Dallas, Texas 75283-1000
                                  Attention: Cecil G. Edwards, Jr.

                                  Fax No.: (214) 508-0314
                                  Telephone No.: (512) 508-3140

                                  Lending Office for Base Rate Advances:
                                  901 Main Street, 7th Floor
                                  Post Office Box 831000
                                  Dallas, Texas 75283-1000

                                  Lending Office for Eurodollar Advances:
                                  901 Main Street, 7th Floor
                                  Post Office Box 831000
                                  Dallas, Texas 75283-1000


                                       50

<PAGE>





                                                                  EXHIBIT 10.23
                                    TERM NOTE

$25,000,000.00                Boston, Massachusetts               April 26, 1996

     FOR VALUE  RECEIVED,  the  undersigned,  PRIME MEDICAL  SERVICES,  INC. , a
Delaware corporation ("Maker"), hereby promises to pay to the order of THE FIRST
NATIONAL  BANK OF  BOSTON,  a national  banking  association  ("Payee"),  at the
offices of The First National Bank of Boston, as Administrative  Agent (together
with any  successor  as  provided in the  Agreement,  hereinbelow  defined,  the
"Administrative Agent") at 100 Federal Street, Boston, Massachusetts,  in lawful
money of the United States of America,  the principal sum of TWENTY FIVE MILLION
and 00/100 DOLLARS  ($25,000,000.00),  together with interest on the outstanding
principal balance from day to day remaining, as herein specified.

     This Note has been executed and delivered by Maker pursuant to the terms of
that certain  Amended and Restated Loan  Agreement of even date  herewith  among
Maker,  Payee, the Administrative  Agent and each of the other banks which is or
may become a party thereto or any successor or assignee thereof (as the same may
be amended,  supplemented or modified from time to time, the "Agreement") and is
one of the  Term  Notes  described  therein.  Capitalized  terms  used  and  not
otherwise  defined  herein  shall  have the same  meanings  as set  forth in the
Agreement.

     Reference is hereby made to the Agreement  for  provisions  affecting  this
Note, including, without limitation,  provisions regarding payments, prepayments
(optional and mandatory),  Events of Default and the Administrative  Agent's and
Payee's rights as a result of the occurrence thereof.

     The  outstanding  principal  balance  hereof shall bear  interest  prior to
maturity at a varying rate per annum which shall from day to day be equal to the
lesser of (a) the Maximum Rate, or (b) the Applicable Rate in effect from day to
day,  each  such  change in the rate of  interest  charged  hereunder  to become
effective,  without notice to Maker, on the effective date of each change in the
Applicable Rate or the Maximum Rate, as the case may be; provided,  however,  if
at any time the Applicable  Rate shall exceed the Maximum Rate,  thereby causing
the interest rate hereon to be limited to the Maximum Rate,  then any subsequent
reduction in the  Applicable  Rate shall not reduce the rate of interest  hereon
below the Maximum Rate until the total amount of interest  accrued hereon equals
the amount of interest which would have accrued  hereon if the  Applicable  Rate
had at all times  been in  effect.  The  unpaid  principal  balance  of, and all
accrued and unpaid  interest on, this Note shall be due and payable on the dates
and at the times set forth in the Agreement. All past-due principal and interest
shall bear interest at the Default Rate.

     Notwithstanding anything to the contrary contained herein, no provisions of
this Note shall  require  the  payment or permit the  collection  of interest in
excess of the Maximum  Rate. If any excess of interest in such respect is herein
provided  for,  or shall  be  adjudicated  to be so  provided,  in this  Note or
otherwise in  connection  with this loan  transaction,  the  provisions  of this
paragraph  shall  govern  and  prevail,  and  neither  Maker  nor the  sureties,
guarantors,  successors or assigns of Maker shall be obligated to pay the excess
amount of such interest,  or any other excess sum paid for the use,  forbearance
or  detention  of sums loaned  pursuant  hereto.  If for any reason  interest in
excess of the Maximum Rate shall be deemed charged, required or permitted by any
court of competent  jurisdiction,  any such excess shall be applied as a payment
and reduction of the principal of  indebtedness  evidenced by this Note; and, if
the principal  amount hereof has been paid in full,  any remaining  excess shall
forthwith be paid to Maker.  In determining  whether or not the interest paid or
payable  exceeds the Maximum Rate,  Maker,  the  Administrative  Agent and Payee
shall,  to  the  extent  permitted  by  applicable  law,  (i)  characterize  any
non-principal  payment as an expense,  fee, or premium  rather than as interest,
(ii) exclude voluntary  prepayments and the effects thereof, and (iii) amortize,
prorate,  allocate,  and  spread in equal or unequal  parts the total  amount of
interest throughout the entire  contemplated term of the indebtedness  evidenced
by this  Note so that the  interest  for the  entire  term does not  exceed  the
Maximum Rate.


<PAGE>





     Upon the occurrence of an Event of Default,  the  Administrative  Agent may
(and if  directed  by the  Required  Banks,  shall)  declare  the entire  unpaid
principal  of and  accrued  interest  on this Note  immediately  due and payable
without notice, demand or presentment,  all of which are hereby waived, and upon
such  declaration,  the same  shall  become  and  shall be  immediately  due and
payable,  and the  Administrative  Agent  shall have the right to  foreclose  or
otherwise enforce all Liens or security  interests,  securing payment hereof, or
any part  hereof,  and  offset  against  this  Note any sum or sums  owed by the
Administrative  Agent,  Payee or the  holder  hereof  to Maker.  Failure  of the
Administrative  Agent,  Payee or the holder hereof to exercise this option shall
not constitute a waiver of the right to exercise the same upon the occurrence of
a subsequent Event of Default.

     If the Administrative  Agent, Payee or the holder hereof expends any effort
in any attempt to enforce  payment of all or any part or  installment of any sum
due the holder hereunder,  or if this Note is placed in the hands of an attorney
for  collection,  or if it is  collected  through any legal  proceedings,  Maker
agrees to pay all  costs,  expenses,  and fees  incurred  by the  Administrative
Agent, Payee or the holder, including reasonable. attorneys' fees.

     This Note shall be governed by and construed in accordance with the laws of
the Commonwealth of  Massachusetts  and the applicable laws of the United States
of America.

     Except as  provided in the  Agreement,  Maker and each  surety,  guarantor,
endorser,  and other party ever liable for payment of any sums of money  payable
on this Note  jointly  and  severally  waive  notice,  presentment,  demand  for
payment,  protest,  notice of protest and  non-payment  or  dishonor,  notice of
acceleration,  notice  of  intent to  accelerate,  notice  of intent to  demand,
diligence in  collecting,  grace,  and all other  formalities  of any kind,  and
consent to all  extensions  without notice for any period or periods of time and
partial payments, before or after maturity, and any impairment of any Collateral
securing this Note, all without prejudice to the Administrative  Agent, Payee or
the holder. The Administrative  Agent, Payee and the holder shall similarly have
the  right to deal in any way,  at any time,  with one or more of the  foregoing
parties  without  notice to any  other  party,  and to grant any such  party any
extensions  of time for  payment of any of said  indebtedness,  or to release or
substitute  part or all of the  Collateral  securing  this Note, or to grant any
other indulgences or forbearances whatsoever,  without notice to any other party
and without in any way affecting the personal liability of any party hereunder.


                                            PRIME MEDICAL SERVICES, INC.

                                            By:____________________________
                                               Cheryl Williams
                                               Vice President - Finance




<PAGE>






                                                                 EXHIBIT 10.24

                                    TERM NOTE

$25,000,000.00                Boston, Massachusetts              April 26, 1996

     FOR VALUE  RECEIVED,  the  undersigned,  PRIME MEDICAL  SERVICES,  INC. , a
Delaware  corporation  ("Maker"),  hereby  promises  to  pay  to  the  order  of
NATIONSBANK OF TEXAS,  N.A., a national banking  association  ("Payee"),  at the
offices of The First National Bank of Boston, as Administrative  Agent (together
with any  successor  as  provided in the  Agreement,  hereinbelow  defined,  the
"Administrative Agent") at 100 Federal Street, Boston, Massachusetts,  in lawful
money of the United States of America,  the principal sum of TWENTY FIVE MILLION
and 00/100 DOLLARS  ($25,000,000.00),  together with interest on the outstanding
principal balance from day to day remaining, as herein specified.

     This Note has been executed and delivered by Maker pursuant to the terms of
that certain  Amended and Restated Loan  Agreement of even date  herewith  among
Maker,  Payee, the Administrative  Agent and each of the other banks which is or
may become a party thereto or any successor or assignee thereof (as the same may
be amended,  supplemented or modified from time to time, the "Agreement") and is
one of the  Term  Notes  described  therein.  Capitalized  terms  used  and  not
otherwise  defined  herein  shall  have the same  meanings  as set  forth in the
Agreement.

     Reference is hereby made to the Agreement  for  provisions  affecting  this
Note, including, without limitation,  provisions regarding payments, prepayments
(optional and mandatory),  Events of Default and the Administrative  Agent's and
Payee's rights as a result of the occurrence thereof.

     The  outstanding  principal  balance  hereof shall bear  interest  prior to
maturity at a varying rate per annum which shall from day to day be equal to the
lesser of (a) the Maximum Rate, or (b) the Applicable Rate in effect from day to
day,  each  such  change in the rate of  interest  charged  hereunder  to become
effective,  without notice to Maker, on the effective date of each change in the
Applicable Rate or the Maximum Rate, as the case may be; provided,  however,  if
at any time the Applicable  Rate shall exceed the Maximum Rate,  thereby causing
the interest rate hereon to be limited to the Maximum Rate,  then any subsequent
reduction in the  Applicable  Rate shall not reduce the rate of interest  hereon
below the Maximum Rate until the total amount of interest  accrued hereon equals
the amount of interest which would have accrued  hereon if the  Applicable  Rate
had at all times  been in  effect.  The  unpaid  principal  balance  of, and all
accrued and unpaid  interest on, this Note shall be due and payable on the dates
and at the times set forth in the Agreement. All past-due principal and interest
shall bear interest at the Default Rate.

     Notwithstanding anything to the contrary contained herein, no provisions of
this Note shall  require  the  payment or permit the  collection  of interest in
excess of the Maximum  Rate. If any excess of interest in such respect is herein
provided  for,  or shall  be  adjudicated  to be so  provided,  in this  Note or
otherwise in  connection  with this loan  transaction,  the  provisions  of this
paragraph  shall  govern  and  prevail,  and  neither  Maker  nor the  sureties,
guarantors,  successors or assigns of Maker shall be obligated to pay the excess
amount of such interest,  or any other excess sum paid for the use,  forbearance
or  detention  of sums loaned  pursuant  hereto.  If for any reason  interest in
excess of the Maximum Rate shall be deemed charged, required or permitted by any
court of competent  jurisdiction,  any such excess shall be applied as a payment
and reduction of the principal of  indebtedness  evidenced by this Note; and, if
the principal  amount hereof has been paid in full,  any remaining  excess shall
forthwith be paid to Maker.  In determining  whether or not the interest paid or
payable  exceeds the Maximum Rate,  Maker,  the  Administrative  Agent and Payee
shall,  to  the  extent  permitted  by  applicable  law,  (i)  characterize  any
non-principal  payment as an expense,  fee, or premium  rather than as interest,
(ii) exclude voluntary  prepayments and the effects thereof, and (iii) amortize,
prorate,  allocate,  and  spread in equal or unequal  parts the total  amount of
interest throughout the entire  contemplated term of the indebtedness  evidenced
by this  Note so that the  interest  for the  entire  term does not  exceed  the
Maximum Rate.


<PAGE>





     Upon the occurrence of an Event of Default,  the  Administrative  Agent may
(and if  directed  by the  Required  Banks,  shall)  declare  the entire  unpaid
principal  of and  accrued  interest  on this Note  immediately  due and payable
without notice, demand or presentment,  all of which are hereby waived, and upon
such  declaration,  the same  shall  become  and  shall be  immediately  due and
payable,  and the  Administrative  Agent  shall have the right to  foreclose  or
otherwise enforce all Liens or security  interests,  securing payment hereof, or
any part  hereof,  and  offset  against  this  Note any sum or sums  owed by the
Administrative  Agent,  Payee or the  holder  hereof  to Maker.  Failure  of the
Administrative  Agent,  Payee or the holder hereof to exercise this option shall
not constitute a waiver of the right to exercise the same upon the occurrence of
a subsequent Event of Default.

     If the Administrative  Agent, Payee or the holder hereof expends any effort
in any attempt to enforce  payment of all or any part or  installment of any sum
due the holder hereunder,  or if this Note is placed in the hands of an attorney
for  collection,  or if it is  collected  through any legal  proceedings,  Maker
agrees to pay all  costs,  expenses,  and fees  incurred  by the  Administrative
Agent, Payee or the holder, including reasonable. attorneys' fees.

     This Note shall be governed by and construed in accordance with the laws of
the Commonwealth of  Massachusetts  and the applicable laws of the United States
of America.

     Except as  provided in the  Agreement,  Maker and each  surety,  guarantor,
endorser,  and other party ever liable for payment of any sums of money  payable
on this Note  jointly  and  severally  waive  notice,  presentment,  demand  for
payment,  protest,  notice of protest and  non-payment  or  dishonor,  notice of
acceleration,  notice  of  intent to  accelerate,  notice  of intent to  demand,
diligence in  collecting,  grace,  and all other  formalities  of any kind,  and
consent to all  extensions  without notice for any period or periods of time and
partial payments, before or after maturity, and any impairment of any Collateral
securing this Note, all without prejudice to the Administrative  Agent, Payee or
the holder. The Administrative  Agent, Payee and the holder shall similarly have
the  right to deal in any way,  at any time,  with one or more of the  foregoing
parties  without  notice to any  other  party,  and to grant any such  party any
extensions  of time for  payment of any of said  indebtedness,  or to release or
substitute  part or all of the  Collateral  securing  this Note, or to grant any
other indulgences or forbearances whatsoever,  without notice to any other party
and without in any way affecting the personal liability of any party hereunder.


                                            PRIME MEDICAL SERVICES, INC.

                                            By:_____________________________

                                               Cheryl Williams
                                               Vice President - Finance
















<PAGE>





                                                                EXHIBIT 10.25

                              REVOLVING CREDIT NOTE

$20,000,000.00                Boston, Massachusetts             April 26, 1996

     FOR VALUE  RECEIVED,  the  undersigned,  PRIME  MEDICAL  SERVICES,  INC., a
Delaware corporation ("Maker"), hereby promises to pay to the order of THE FIRST
NATIONAL  BANK OF  BOSTON,  a national  banking  association  ("Payee"),  at the
offices of The First National Bank of Boston, as Administrative  Agent (together
with any  successor  as  provided in the  Agreement,  hereinbelow  defined,  the
"Administrative Agent") at 100 Federal Street, Boston,  Massachusetts,  on April
30, 2001, in lawful money of the United States of America,  the principal sum of
TWENTY MILLION AND 00/100 DOLLARS ($20,000,000.00), or so much thereof as may be
advanced and outstanding hereunder together with the interest on the outstanding
principal balance from day to day remaining, as herein specified.

     This Note has been executed and delivered by Maker pursuant to the terms of
that certain  Amended and Restated Loan  Agreement of even date  herewith  among
Maker,  Payee, the Administrative  Agent and each of the other Banks which is or
may become a party thereto or any successor or assignee thereof (as the same may
be amended,  supplemented or modified from time to time, the "Agreement") and is
one of the Revolving Credit Notes described therein.  Capitalized terms used and
not  otherwise  defined  herein shall have the same meanings as set forth in the
Agreement.

     Reference is hereby made to the Agreement  for  provisions  affecting  this
Note, including, without limitation,  provisions regarding payments, prepayments
(optional and mandatory),  Events of Default and the Administrative  Agent's and
Payee's right as a result of the occurrence thereof.

     The  outstanding  principal  balance  hereof shall bear  interest  prior to
maturity at a varying rate per annum which shall from day to day be equal to the
lesser of (a) the Maximum Rate, or (b) the Applicable Rate in effect from day to
day,  each  such  change in the rate of  interest  charged  hereunder  to become
effective,  without notice to Maker, on the effective date of each change in the
Applicable Rate or the Maximum Rate, as the case may be; provided,  however,  if
at any time the Applicable  Rate shall exceed the Maximum Rate,  thereby causing
the interest rate hereon to be limited to the Maximum Rate,  then any subsequent
reduction in the  Applicable  Rate shall not reduce the rate of interest  hereon
below the Maximum Rate until the total amount of interest  accrued hereon equals
the amount of interest which would have accrued  hereon if the  Applicable  Rate
had at all times been in effect.  Accrued and unpaid interest on this Note shall
be due and  payable  on each  Payment  Date  and on the  Termination  Date.  All
past-due principal and interest shall bear interest as the Default Rate.

     Notwithstanding anything to the contrary contained herein, no provisions of
this Note shall  require  the  payment or permit the  collection  of interest in
excess of the Maximum  Rate. If and excess of interest in such respect is herein
provided  for,  or shall  be  adjudicated  to be so  provided,  in this  Note or
otherwise in  connection  with this loan  transaction,  the  provisions  of this
paragraph  shall  govern  and  prevail,  and  neither  Maker  nor the  sureties,
guarantors,  successors or assigns of Maker shall be obligated to pay the excess
amount of such interest,  or any other excess sum paid for the use,  forbearance
or  detention  of sums loaned  pursuant  hereto.  If for any reason  interest in
excess of the Maximum Rate shall be deemed charged, required or permitted by any
court of competent  jurisdiction,  any such excess shall be applied as a payment
and reduction of the principal of  indebtedness  evidenced by this Note; and, if
the principal  amount hereof has been paid in full,  any remaining  excess shall
forthwith be paid to Maker.  In determining  whether or not the interest paid or
payable  exceeds the Maximum Rate,  Maker,  the  Administrative  Agent and Payee
shall,  to  the  extent  permitted  by  applicable  law,  (i)  characterize  any
non-principal  payment as an expense,  fee, or premium  rather than as interest,
(ii) exclude voluntary  prepayments and the effects thereof, and (iii) amortize,
prorate,  allocate,  and  spread in equal or unequal  parts the total  amount of
interest throughout the entire contemplated


<PAGE>




term of the  indebtedness  evidenced  by this Note so that the  interest for the
entire term does not exceed the Maximum Rate.

     Upon the occurrence of an Event of Default,  the  Administrative  Agent may
(and if  directed  by the  Required  Banks,  shall)  declare  the entire  unpaid
principal  of and  accrued  interest  on this Note  immediately  due and payable
without notice, demand or presentment,  all of which are hereby waived, and upon
such  declaration,  the same  shall  become  and  shall be  immediately  due and
payable,  and the  Administrative  Agent  shall have the right to  foreclose  or
otherwise  enforce all Liens or security  interests  securing payment hereof, or
any part  hereof,  and  offset  against  this  Note any sum or sums  owed by the
Administrative  Agent,  Payee or the  holder  hereof  to Maker.  Failure  of the
Administrative  Agent,  Payee or the holder hereof to exercise this option shall
not constitute a waiver of the right to exercise the same upon the occurrence of
a subsequent Event of Default.

     If the Administrative  Agent, Payee or the holder hereof expends any effort
in any attempt to enforce  payment of all or any part or  installment of any sum
due the holder hereunder,  or if this Note is placed in the hands of an attorney
for  collection,  or if it is  collected  through any legal  proceedings,  Maker
agrees to pay all  costs,  expenses,  and fees  incurred  by the  Administrative
Agent, or the holder, including reasonable attorneys' fees.

     This Note shall be governed by and construed in accordance with the laws of
the Commonwealth of  Massachusetts  and the applicable laws of the United States
of America.

     Except as  provided in the  Agreement,  Maker and each  surety,  guarantor,
endorser,  and other party ever liable for payment of any sums of money  payable
on this Note  jointly  and  severally  waive  notice,  presentment,  demand  for
payment,  protest,  notice of protest and  non-payment  or  dishonor,  notice of
acceleration,  notice  of  intent to  accelerate,  notice  of intent to  demand,
diligence in  collecting,  grace,  and all other  formalities  of any kind,  and
consent to all  extensions  without notice for any period or periods of time and
partial payments, before or after maturity, and any impairment of any Collateral
securing this Note, all without prejudice to the Administrative  Agent, Payee or
the holder. The Administrative  Agent, Payee and the holder shall similarly have
the  right to deal in any way,  at any time,  with one or more of the  foregoing
parties  without  notice to any  other  party,  and to grant any such  party any
extensions  of time for  payment of any of said  indebtedness,  or to release or
substitute  part or all of the  Collateral  securing  this Note, or to grant any
other indulgences or forbearances whatsoever,  without notice to any other party
and without in any way affecting the personal liability of any party hereunder.

     Maker hereby  authorizes  the  Administrative  Agent,  Payee and the holder
hereof to  endorse on the  Schedule  attached  to this Note or any  continuation
thereof  or to record  in their  internal  records  all  Advances  made to Maker
hereunder  and all  payments  made on account of the  principal  thereof,  which
endorsements  or recordings  shall be prima facie evidence as to the outstanding
principal  amount  of  this  Note;   provided,   however,  any  failure  by  the
Administrative Agent, Payee or the holder hereof to make any such endorsement or
recording shall not limit or otherwise affect the obligations of Maker under the
Agreement or this Note.

                                            PRIME MEDICAL SERVICES, INC.

                                            By:_______________________________
                                               Cheryl Williams
                                               Vice President - Finance


<PAGE>




                                    SCHEDULE



Date        Advance           Principal Payment             Balance
- -----       --------          -----------------             --------



















<PAGE>





                                                                EXHIBIT 10.26
                              REVOLVING CREDIT NOTE

$20,000,000.00                Boston, Massachusetts             April 26, 1996

     FOR VALUE  RECEIVED,  the  undersigned,  PRIME  MEDICAL  SERVICES,  INC., a
Delaware  corporation  ("Maker"),  hereby  promises  to  pay  to  the  order  of
NATIONSBANK OF TEXAS,  N.A., a national banking  association  ("Payee"),  at the
offices of The First National Bank of Boston, as Administrative  Agent (together
with any  successor  as  provided in the  Agreement,  hereinbelow  defined,  the
"Administrative Agent") at 100 Federal Street, Boston,  Massachusetts,  on April
30, 2001, in lawful money of the United States of America,  the principal sum of
TWENTY MILLION AND 00/100 DOLLARS ($20,000,000.00), or so much thereof as may be
advanced and outstanding hereunder together with the interest on the outstanding
principal balance from day to day remaining, as herein specified.

     This Note has been executed and delivered by Maker pursuant to the terms of
that certain  Amended and Restated Loan  Agreement of even date  herewith  among
Maker,  Payee, the Administrative  Agent and each of the other Banks which is or
may become a party thereto or any successor or assignee thereof (as the same may
be amended,  supplemented or modified from time to time, the "Agreement") and is
one of the Revolving Credit Notes described therein.  Capitalized terms used and
not  otherwise  defined  herein shall have the same meanings as set forth in the
Agreement.

     Reference is hereby made to the Agreement  for  provisions  affecting  this
Note, including, without limitation,  provisions regarding payments, prepayments
(optional and mandatory),  Events of Default and the Administrative  Agent's and
Payee's right as a result of the occurrence thereof.

     The  outstanding  principal  balance  hereof shall bear  interest  prior to
maturity at a varying rate per annum which shall from day to day be equal to the
lesser of (a) the Maximum Rate, or (b) the Applicable Rate in effect from day to
day,  each  such  change in the rate of  interest  charged  hereunder  to become
effective,  without notice to Maker, on the effective date of each change in the
Applicable Rate or the Maximum Rate, as the case may be; provided,  however,  if
at any time the Applicable  Rate shall exceed the Maximum Rate,  thereby causing
the interest rate hereon to be limited to the Maximum Rate,  then any subsequent
reduction in the  Applicable  Rate shall not reduce the rate of interest  hereon
below the Maximum Rate until the total amount of interest  accrued hereon equals
the amount of interest which would have accrued  hereon if the  Applicable  Rate
had at all times been in effect.  Accrued and unpaid interest on this Note shall
be due and  payable  on each  Payment  Date  and on the  Termination  Date.  All
past-due principal and interest shall bear interest as the Default Rate.

     Notwithstanding anything to the contrary contained herein, no provisions of
this Note shall  require  the  payment or permit the  collection  of interest in
excess of the Maximum  Rate. If and excess of interest in such respect is herein
provided  for,  or shall  be  adjudicated  to be so  provided,  in this  Note or
otherwise in  connection  with this loan  transaction,  the  provisions  of this
paragraph  shall  govern  and  prevail,  and  neither  Maker  nor the  sureties,
guarantors,  successors or assigns of Maker shall be obligated to pay the excess
amount of such interest,  or any other excess sum paid for the use,  forbearance
or  detention  of sums loaned  pursuant  hereto.  If for any reason  interest in
excess of the Maximum Rate shall be deemed charged, required or permitted by any
court of competent  jurisdiction,  any such excess shall be applied as a payment
and reduction of the principal of  indebtedness  evidenced by this Note; and, if
the principal  amount hereof has been paid in full,  any remaining  excess shall
forthwith be paid to Maker.  In determining  whether or not the interest paid or
payable  exceeds the Maximum Rate,  Maker,  the  Administrative  Agent and Payee
shall,  to  the  extent  permitted  by  applicable  law,  (i)  characterize  any
non-principal  payment as an expense,  fee, or premium  rather than as interest,
(ii) exclude voluntary  prepayments and the effects thereof, and (iii) amortize,
prorate,  allocate,  and  spread in equal or unequal  parts the total  amount of
interest throughout the entire  contemplated term of the indebtedness  evidenced
by this  Note so that the  interest  for the  entire  term does not  exceed  the
Maximum Rate.


<PAGE>





     Upon the occurrence of an Event of Default,  the  Administrative  Agent may
(and if  directed  by the  Required  Banks,  shall)  declare  the entire  unpaid
principal  of and  accrued  interest  on this Note  immediately  due and payable
without notice, demand or presentment,  all of which are hereby waived, and upon
such  declaration,  the same  shall  become  and  shall be  immediately  due and
payable,  and the  Administrative  Agent  shall have the right to  foreclose  or
otherwise  enforce all Liens or security  interests  securing payment hereof, or
any part  hereof,  and  offset  against  this  Note any sum or sums  owed by the
Administrative  Agent,  Payee or the  holder  hereof  to Maker.  Failure  of the
Administrative  Agent,  Payee or the holder hereof to exercise this option shall
not constitute a waiver of the right to exercise the same upon the occurrence of
a subsequent Event of Default.

     If the Administrative  Agent, Payee or the holder hereof expends any effort
in any attempt to enforce  payment of all or any part or  installment of any sum
due the holder hereunder,  or if this Note is placed in the hands of an attorney
for  collection,  or if it is  collected  through any legal  proceedings,  Maker
agrees to pay all  costs,  expenses,  and fees  incurred  by the  Administrative
Agent, or the holder, including reasonable attorneys' fees.

     This Note shall be governed by and construed in accordance with the laws of
the Commonwealth of  Massachusetts  and the applicable laws of the United States
of America.

     Except as  provided in the  Agreement,  Maker and each  surety,  guarantor,
endorser,  and other party ever liable for payment of any sums of money  payable
on this Note  jointly  and  severally  waive  notice,  presentment,  demand  for
payment,  protest,  notice of protest and  non-payment  or  dishonor,  notice of
acceleration,  notice  of  intent to  accelerate,  notice  of intent to  demand,
diligence in  collecting,  grace,  and all other  formalities  of any kind,  and
consent to all  extensions  without notice for any period or periods of time and
partial payments, before or after maturity, and any impairment of any Collateral
securing this Note, all without prejudice to the Administrative  Agent, Payee or
the holder. The Administrative  Agent, Payee and the holder shall similarly have
the  right to deal in any way,  at any time,  with one or more of the  foregoing
parties  without  notice to any  other  party,  and to grant any such  party any
extensions  of time for  payment of any of said  indebtedness,  or to release or
substitute  part or all of the  Collateral  securing  this Note, or to grant any
other indulgences or forbearances whatsoever,  without notice to any other party
and without in any way affecting the personal liability of any party hereunder.

         Maker hereby authorizes the Administrative  Agent, Payee and the holder
hereof to  endorse on the  Schedule  attached  to this Note or any  continuation
thereof  or to record  in their  internal  records  all  Advances  made to Maker
hereunder  and all  payments  made on account of the  principal  thereof,  which
endorsements  or recordings  shall be prima facie evidence as to the outstanding
principal  amount  of  this  Note;   provided,   however,  any  failure  by  the
Administrative Agent, Payee or the holder hereof to make any such endorsement or
recording shall not limit or otherwise affect the obligations of Maker under the
Agreement or this Note.

                                            PRIME MEDICAL SERVICES, INC.

                                            By:_______________________________
                                               Cheryl Williams
                                               Vice President - Finance


<PAGE>




                                    SCHEDULE



Date                Advance             Principal Payment             Balance
- -----               --------            -----------------             --------



















<PAGE>



                                                                 EXHIBIT 10.33
                              EMPLOYMENT AGREEMENT


     THIS EMPLOYMENT  AGREEMENT (this  "Agreement") is entered into as of May 1,
1996, by and between PRIME MEDICAL SERVICES,  INC., a Delaware  Corporation (the
"Company"),  and JOSEPH JENKINS,  M.D.,  J.D., a resident of North Carolina (the
"Executive").

                                    RECITALS

     The Company is engaged in the business of (i)  developing  new  lithotripsy
clinics,  (ii) owning and operating  lithotripsy  clinics,  and (iii) serving as
general  partner  and  management  agent  for  operational  lithotripsy  clinics
throughout the United States. The Executive is experienced in, and knowledgeable
concerning,  certain  aspects of the business of the Company.  The Executive has
heretofore  been employed by a predecessor  to the Company,  and the Company and
the  Executive  desire  to  continue  the  employment  of the  Executive  as the
President of the Company on the terms set forth in this Agreement.

     NOW  THEREFORE,  for and in  consideration  of the  premises and the mutual
covenants and agreements provided for herein, the parties agree as follows:

     1. Employment and Duties.  The Company hereby employs the Executive  during
the term of this Agreement, and the Executive hereby accepts such employment, as
the President  and Chief  Executive  Officer of the Company.  During the term of
this  Agreement,  the  Executive  shall  provide  to the  Company  the  services
consistent with that of the President and Chief Executive Officer of the Company
as set forth in the By-Laws of the Company,  and as  determined  by the Board of
Directors  of the  Company.  Notwithstanding  the  foregoing,  without the prior
consent  of the  Executive,  his duties  hereunder  may not be (i)  expanded  or
modified  substantially from those set forth in this Section or (ii) modified or
expanded  in any way that would  require him to relocate  his  residence  from a
reasonable  automobile  commuting distance from Fayetteville,  North Carolina or
make it  impractical  for him to continue to reside there or cause him to reside
away from there for  extended  periods of time,  unless  the  Executive  and the
Chairman of the Board of Directors of the Company mutually agree otherwise.

     2. Duration and Termination.

     a.  Duration.  The initial term of this  Agreement  shall begin on the date
hereof and end on April 30, 1998,  unless this  Agreement  is sooner  terminated
pursuant to Section 2.b. hereof or the term is extended pursuant to this Section
2.a.  Unless the Company  provides  written notice to the Executive on or before
October 31, 1997, or on or before  October 31 of each year  thereafter,  that it
does not desire to extend the term of this Agreement, the term of this Agreement
shall be extended automatically for an additional one-year period. References in
this  Agreement  to the "term" of this  Agreement  mean the initial term and any
extensions thereof as provided pursuant to this Section 2.a.

     b.  Termination.  This  Agreement  may be  terminated  during  its  term as
follows:


<PAGE>



     (i) Upon Death or Disability.  This Agreement shall terminate automatically
upon the death or disability of the Executive.  For purposes of this  Agreement,
"disability"  means the  Executive's  inability  to  substantially  perform  the
services set forth in Section 2 hereto as a result of his physical incapacity or
mental incompetence, or both, provided such inability has continued for a period
of not less than six consecutive  months or for shorter periods  aggregating six
consecutive  months during any  consecutive  twelve-month  period,  and which in
either  case must be  evidenced  by a  written  certification  furnished  to the
Company and to the Executive by a physician selected by agreement of the Company
and the Executive.

     (ii) By the  Executive.  The Executive may terminate  this Agreement at any
time during its term by providing  sixty days' prior written notice to the Board
of Directors of the Company of such termination.

     (iii) By Written Agreement of Parties.  This Agreement may be terminated at
any time by the mutual written agreement of the Company and the Executive.

     (iv) By the Company "for Cause".  The Company may terminate  this Agreement
at any time during its term "for cause" by providing  sixty days' prior  written
notice to the Executive,  which notice must specifically describe the conduct of
the Executive providing the Company with cause to terminate this Agreement.  For
purposes  of  this  Agreement,  "for  cause"  means  (i) the  conviction  of the
Executive  of a felony  which  renders  him unable to provide to the Company the
services set forth in Section 2 hereto;  (ii) the commission by the Executive of
an act of fraud,  misappropriation  of funds or  embezzlement in connection with
his  employment  hereunder;  (iii) the  intentional  failure of the Executive to
perform  his  duties  hereunder;  or (iv) the  breach  by the  Executive  of any
material  provision of the  Agreement  that is not remedied  within  thirty days
after the Company provides written notice thereof to the Executive.

     (v) By the Company Other Than "for Cause".  The Company may terminate  this
Agreement  at any time during its term for any reason other than "for cause" (as
defined in Section  2(b)(iv) above) by providing sixty days prior written notice
to the Executive; provided that if the Company terminates the Agreement pursuant
to this Section  2(b)(v),  the Company shall continue to pay compensation to the
Executive  for the  remainder  of the term at the  highest  annual  rate of cash
salary in effect  under  Section  3 hereof at any time  during  the term of this
Agreement.  Such annual  payments  shall be made in equal monthly  installments,
each payable in arrears to the  Executive by the tenth day of each month for the
remainder of the term of the Agreement.  In the event of a termination  pursuant
to this Section 2(b)(v),  any  NonCompetition  Agreement between the Company and
the Executive shall continue in all respects,  except that the territory covered
by any NonCompetition  Agreement shall be limited to the markets serviced by the
Company and Lithotripters at the time of termination.

                                        2

<PAGE>




     3. Annual Compensation. Commencing on the date hereof and continuing during
the term of this Agreement,  the Company shall pay to the Executive compensation
at the rate of $325,000 per annum,  payable in twelve equal monthly installments
of  $27,083.33,  each  payable in arrears to the  Executive by the tenth of each
month. The rate of annual  compensation  provided for herein shall be subject to
review and increase in accordance  with the normal  salary  review  policies and
procedures of the Company applicable to its executive  officers,  but nothing in
this  sentence  shall be  interpreted  as  requiring  the  Company  to  increase
compensation  of the  Executive in any year. In no event shall the annual salary
payable hereunder be less than $325,000.

     4. Bonus Arrangement.  In addition to annual  compensation  provided for in
Section 3 hereof,  the Company may award to the  Executive  performance  bonuses
based upon the performance of the Company and the Executive,  as determined from
time to time by the Board of  Directors  of the  Company,  but nothing  hteherin
shall be  interpreted  as obligating the Company to pay a bonus to the Executive
in any year, and the decision to pay or not to pay a bonus for any year shall be
discretionary with the Company.

     5.  Executive  Benefits.  Effective as of the date of this  Agreement,  the
Executive  shall be entitled to participate  in benefit  programs of the Company
that generally are made available to its executive  officers,  as in effect from
time to time,  including without limitation  medical insurance,  life insurance,
disability  income  plan,  retirement  benefits  pursuant  to a  formal  plan or
otherwise,  and vacation  policies (four week minimum).  Benefits payable by the
Company shall include, without limitation, the following:

     (i) Continuation of Executive Club Membership (including monthly dues);

     (ii) All expenses  associated with the provision,  maintenance and use of a
cellular car phone;

     (iii)  Payment of  professional  legal and  medical  magazine  and  journal
subscriptions;

     (iv)  Continuation  of existing  airline travel clubs (e.g.  U.S. Air Club,
Delta Crown Room, Admiral Club, etc.) and benefits;

     (v) Payment of medical malpractice premiums;

     (vi) Payment of medical licenses and medical and DEA registrations;

     (vii) Payment for membership and dues in professional  medical associations
and  societies,   including,   without  limitation,   ALS,  AUA,  AMA,  Carolina
Urological,  North Carolina Urological, North Carolina Medical Society, American
College of Surgeons,  and Southeastern  Section of AUA, and payment of all costs
associated with attending any meetings of the above; and


                                        3

<PAGE>



     (viii)  Payment  of  all  costs  of  registration  and  attendance  to  any
continuing medical education  meetings,  subject to prior approval of attendance
at any such meetings by the Chairman of the Board of Directors of the Company.

     6. Reimbursement of Expenses. The Company shall reimburse the Executive, in
accordance  with the general  policies and practices of the Company as in effect
from time to time, for  out-of-pocket  expenses incurred by the Executive in the
performance of his duties hereunder.

     7. Notices. Any notice required or permitted to be given under the terms of
this Agreement shall be in writing and either hand delivered,  sent by facsimile
transmission or sent by nationally-recognized air courier, as follows:

                  If to the Company:

                  Prime Medical Services, Inc.
                  Kenneth S. Shifrin
                  1301 Capital of Texas Hwy., Ste. C-300, Austin, TX 78746
                  Facsimile Number: (512) 314-4398

                  If to the Executive:

                  Joseph Jenkins, M.D., J.D.
                  Joseph Jenkins, M.D.
                  2008 Litho Place, Fayetteville, NC 28304
                  Facsimile Number: (910) 323-9857

or to such other  address as either party may furnish to the other in accordance
with this  Section 8. Any such  notice  shall be deemed to have been given as of
the date hand  delivered  or sent by  facsimile or one day after it is deposited
for delivery with a  nationally-recognized  air courier (properly  addressed and
with charges prepaid).

     8.  Assignment.  This Agreement is personal to each of the parties  hereto,
and  neither  party  may  assign  nor  delegate  any of his  or  its  rights  or
obligations  hereunder  without first obtaining the written consent of the other
party.

     9. Burden and Benefit. This Agreement shall be binding upon and shall inure
to the benefit of the Company and the Executive and their  respective  permitted
successors and assigns. As used herein, the term "successors" shall be deemed to
refer with equal force and effect to any  corporate  or other  successor  of the
Company which shall acquire, directly or indirectly,  by merger,  consolidation,
purchase or otherwise all or subsequently  all of the assets or capital stock of
the Company.

     10. Entire  Agreement.  This  Agreement  contains the entire  agreement and
understanding by and between the Company and the Executive with respect to the

                                        4

<PAGE>



employment of the Executive by the Company.  This Agreement  supersedes all
prior undertakings and agreements, written or oral, as may have existed prior to
the date  hereof  between  the Company  and the  Executive  with  respect to the
employment of the Executive by the Company.

     11. Amendment; Waiver. No change or modification of this Agreement shall be
valid or binding unless in writing and signed by the party intended to be bound.
No waiver of any  provision of this  Agreement  shall be valid unless in writing
and  signed by the party  against  whom the waiver is sought to be  enforced.  A
valid waiver of any provision of this Agreement shall be limited to the instance
recited in such writing and, unless  otherwise  expressly  stated,  shall not be
effective as a continuing waiver or repeal of such provision.

     12.  Severability.  In the event that any provision of this Agreement shall
be deemed to be invalid or unenforceable for any reason whatsoever, it is agreed
that such invalidity or unenforceability shall not affect any other provision of
this Agreement;  the remaining terms,  covenants,  restrictions or provisions in
this Agreement shall remain in full force and effect; and any court of competent
jurisdictions  may so modify the  objectionable  provision  as to make it valid,
reasonable and enforceable.

     13.  Governing  Law. This  Agreement  shall be governed by and construed in
accordance with the laws of the State of North Carolina  applicable to contracts
made and to be wholly performed within the State.

     14.   Counterparts.   This  Agreement  may  be  executed  in  one  or  more
counterparts,  each of  which  shall be  deemed  an  original,  but all of which
together shall constitute one and the same instrument.


     IN WITNESS  WHEREOF,  the parties  hereto have executed and delivered  this
Agreement as of the day and year first above written.

                                             COMPANY:

                                             PRIME MEDICAL SERVICES, INC.
                                             a Delaware corporation

                                             By: ____________________________

                                             Name: Kenneth S. Shifrin

                                             Title: Chairman of the Board

                                             EXECUTIVE:

                                             ____________________________(SEAL)
                                             JOSEPH JENKINS, M.D., J.D.

                                        5

<PAGE>



                                            

                                                                      EXHIBIT 11
                  PRIME MEDICAL SERVICES, INC. AND SUBSIDIARIES
                     COMPUTATION OF THE NET INCOME PER SHARE
               FOR THE YEAR ENDED DECEMBER 31, 1996, 1995 AND 1994


(In thousands, net income per share         Primary   Fully diluted
in dollars)                                 earnings     earnings
                                            per share   per share
                                           ----------   ----------           
1996
- ----
Net income applicable to common stock      $    8,961   $    8,961
Adjustment: Add back interest expense
  on convertible debt:                            --           101
                                           ----------   ----------
Adjusted net income applicable 
  to common stock                          $    8,961   $    9,062
                                           ==========   ==========

Average number of shares 
  subscribed & outstanding                     17,633       17,633
Average stock option shares                       579          580
Average convertible debt shares 
  and warrants                                    394          685
                                           ----------   ----------

Shares for earnings calculation                18,606       18,898
                                           ==========   ==========

Net income per share                       $     0.48   $     0.48
                                           ==========   ==========

1995
- ----
Net income applicable to common stock      $    7,204   $    7,204
Adjustment: Add back interest expense 
  on convertible debt:                           --             97
                                           ----------   ----------
Adjusted net income applicable 
  to common stock                          $    7,204   $    7,301
                                           ==========   ==========

Average number of shares subscribed 
  & outstanding                                14,645       14,645
Average reciprocal stockholdings                 (419)        (419)
Average stock option shares                     1,072        1,575
Average convertible debt shares and warrants     --            209
                                           ----------   ----------

Shares for earnings calculation                15,298       16,010
                                           ==========   ==========

Net income per share                       $     0.47   $     0.46
                                           ==========   ==========

                             
1994
- ----
Net income applicable to common stock      $    4,504   $    4,504
                                           ==========   ==========

Average number of shares subscribed 
  & outstanding                                14,535       14,535
Average reciprocal stockholdings                 (734)        (734)
Average stock option shares                       709          849
                                           ----------   ----------

Shares for earnings calculation                14,510       14,650
                                           ==========   ==========

Net income per share                       $     0.31   $     0.31
                                           ==========   ==========

NOTE:  Primary and fully  diluted  income (loss) per share were computed by
dividing net income (loss) by the average number of shares  outstanding plus the
common stock equivalents,  which would arise from the exercise of dilutive stock
options.




                                      A-34







                                                    
                                                                    EXHIBIT 21.1
                  SUBSIDIARIES OF PRIME MEDICAL SERVICES, INC.
                              AS OF MARCH 27, 1997

    EXHIBIT 21.1
    Name of Subsidiary                           State of Incorporation
    -------------------                          --------------------
    Prime Medical Operating, Inc.                Delaware

    Prime Management, Inc.                       Nevada

    Prime Cardiac Rehabilitation Services, Inc.  Delaware

    Prime Diagnostic Services, Inc.              Delaware

    Prime Lithotripsy Services, Inc.             New York

    Prime Kidney Stone Treatment, Inc.           New Jersey

    Prime Diagnostic Corp. of Florida            Delaware

    Prime Lithotripter Operations, Inc.          New York

    Rehab Leasing Corp.                          New York

    Texas Litho, Inc.                            Delaware

    R.R. Litho, Inc.                             Delaware

    Ohio Litho, Inc.                             Delaware

    Alabama Renal Stone Institute, Inc.          Alabama

    Sun Medical Technologies, Inc.               California

    Sun Acquisition, Inc.                        California

    Lithotripters, Inc.                          North Carolina

    FastStart, Inc.                              North Carolina

    National Lithotripters Association, Inc.     North Carolina








                          INDEPENDENT AUDITORS' CONSENT
              ----------------------------------------------------


We consent to incorporation by reference in the registration statements (No. 33-
70478) on Form S-8 and (No.  333-12893) on Form S-3 of Prime  Medical  Services,
Inc. of our report dated February 21, 1997, relating to the consolidated balance
sheets of Prime Medical Services,  Inc. and subsidiaries as of December 31, 1996
and 1995,  and the  related  consolidated  statements  of income,  stockholders'
equity,  and cash  flows for each of the years in the  three-year  period  ended
December 31, 1996, and the related financial  statement  schedule,  which report
appears in the Annual  Report on Form 10-K of Prime Medical  Services,  Inc. for
the year ended December 31, 1996.



/s/ KPMG Peat Marwick, LLP

Austin, Texas
March 27, 1997

<TABLE> <S> <C>


<ARTICLE>                     5
<LEGEND>
This schedule contains summary financial information extracted from the
December 31, 1996 Form 10-K and is qualified in its entirety by reference to 
such financial statements.
</LEGEND>
<MULTIPLIER>                                   1,000
       
<S>                             <C>
<PERIOD-TYPE>                   12-mos
<FISCAL-YEAR-END>                              DEC-31-1996
<PERIOD-START>                                 JAN-01-1996
<PERIOD-END>                                   DEC-31-1996
<CASH>                                          20,096
<SECURITIES>                                         0
<RECEIVABLES>                                   16,346
<ALLOWANCES>                                       335
<INVENTORY>                                          0
<CURRENT-ASSETS>                                40,073
<PP&E>                                          22,452
<DEPRECIATION>                                   7,122
<TOTAL-ASSETS>                                 197,753
<CURRENT-LIABILITIES>                           31,555
<BONDS>                                              0
                                0
                                          0
<COMMON>                                           191
<OTHER-SE>                                      76,236
<TOTAL-LIABILITY-AND-EQUITY>                   197,753
<SALES>                                              0
<TOTAL-REVENUES>                                72,404
<CGS>                                                0
<TOTAL-COSTS>                                   24,799
<OTHER-EXPENSES>                                 7,455
<LOSS-PROVISION>                                   150
<INTEREST-EXPENSE>                               5,977
<INCOME-PRETAX>                                 10,957
<INCOME-TAX>                                     1,996
<INCOME-CONTINUING>                              8,961
<DISCONTINUED>                                       0
<EXTRAORDINARY>                                      0
<CHANGES>                                            0
<NET-INCOME>                                     8,961
<EPS-PRIMARY>                                     0.48
<EPS-DILUTED>                                     0.48
        


</TABLE>


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