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        <ExplanationTxt>UNIVERSITY FAMILY PHYSICIANS IS A SUBSIDIARY IN IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE INTERNAL REVENUE SERVICE (IRS) HAS DETERMINED THAT INDIANA UNIVERSITY HEALTH AND CERTAIN OF ITS AFFILIATED ENTITIES ARE TAX-EXEMPT ORGANIZATIONS AS DEFINED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). INDIANA UNIVERSITY HEALTH AND ITS TAX-EXEMPT AFFILIATES ARE, HOWEVER, SUBJECT TO FEDERAL AND STATE INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER THE PROVISIONS OF IRC SECTION 511. DEFERRED INCOME TAXES WHICH, AS OF DECEMBER 31, 2023 AND 2022, HAVE NO NET CARRYING VALUE, REFLECT THE NET TAX EFFECT OF TEMPORARY DIFFERENCES BETWEEN THE CARRYING AMOUNTS OF ASSETS AND LIABILITIES FOR FINANCIAL REPORTING AND THE AMOUNTS USED FOR INCOME TAX PURPOSES. AS OF DECEMBER 31, 2023 AND 2022, THE INDIANA UNIVERSITY HEALTH SYSTEM HAD GROSS DEFERRED TAX ASSETS OF $141,386,000 AND $145,194,000, RESPECTIVELY, RELATING TO NET OPERATING LOSS CARRYOVERS. MANAGEMENT DETERMINED THAT A FULL VALUATION ALLOWANCE AT DECEMBER 31, 2023 AND 2022 WAS NECESSARY TO REDUCE THE DEFERRED TAX ASSETS TO THE AMOUNT THAT WOULD MORE LIKELY THAN NOT BE REALIZED. BASED ON THE WEIGHT OF THE EVIDENCE, IF IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED, A VALUATION ALLOWANCE TO REDUCE THE DEFERRED TAX ASSETS IS RECORDED. THE DECREASE IN THE GROSS DEFERRED TAX ASSET AND THE VALUATION ALLOWANCE FOR THE CURRENT YEAR IS $3,009,000. AT DECEMBER 31, 2023, INDIANA UNIVERSITY HEALTH SYSTEM HAS AVAILABLE NET OPERATING LOSS CARRYFORWARDS OF $571,690,000, NET OPERATING LOSSES GENERATED FROM 2004 THROUGH 2017 EXPIRE BETWEEN 2024 AND 2037. NET OPERATING LOSSES GENERATED AFTER 2017 DO NOT EXPIRE.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation</FormAndLineReferenceDesc>
        <ExplanationTxt>UNIVERSITY FAMILY PHYSICIANS' PRESIDENT IS EMPLOYED BY IU HEALTH CARE ASSOCIATES. IU HEALTH CARE ASSOCIATES AND OTHER RELATED ORGANIZATIONS HAVE A PROCESS IN PLACE TO DETERMINE THE COMPENSATION FOR ITS OFFICERS AND KEY EMPLOYEES. IU HEALTH HUMAN RESOURCES USES MARKET DATA FROM MULTIPLE COMPENSATION EXPERTS/VENDORS WHO UTILIZE A VARIETY OF METHODS AND PROCEDURES TO OBTAIN COMPENSATION RANGES FOR COMPARABLE OFFICERS AND EMPLOYEE POSITIONS. THIS MARKET DATA AND MULTIPLE OTHER FACTORS (INCLUDING MARKET PAY BENCHMARKS, INTERNAL EQUITY, CANDIDATE/EMPLOYEE QUALIFICATIONS &amp; PERFORMANCE, AND BUSINESS NEEDS) ARE USED TO RECOMMEND COMPENSATION RANGES FOR ITS OFFICERS AND OTHER EMPLOYEES, WHICH ARE THEN USED AS A GUIDE FOR SETTING REASONABLE COMPENSATION BY MANAGEMENT. PLEASE SEE SCHEDULE O FOR ADDITIONAL DETAILS.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan</FormAndLineReferenceDesc>
        <ExplanationTxt>KEVIN B. GEBKE M.D. PARTICIPATES IN AN IU HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, PROVISIONS OF WHICH ARE DESIGNED TO RETAIN ITS CRITICAL EMPLOYEES. THE PLAN PROVIDES FOR AN ADDITIONAL RETIREMENT BENEFIT FOR SERVICE THROUGH NORMAL RETIREMENT OR OTHER KEY DATES. IF THE EXECUTIVE LEAVES PRIOR TO RETIREMENT OR OTHER KEY DATES, THE BENEFIT MAY BE FORFEITED OR REDUCED. EACH OF THE EXECUTIVES LISTED ABOVE HAVE AN AMOUNT INCLUDED IN COLUMN C, DEFERRED COMPENSATION, REPRESENTING THE CURRENT YEAR UNVESTED CONTRIBUTIONS MADE UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THESE AMOUNTS WERE NOT PAID TO THE EXECUTIVES DURING THE YEAR.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 1b INDEPENDENT VOTING MEMBERS</FormAndLineReferenceDesc>
        <ExplanationTxt>UNIVERSITY FAMILY PHYSICIANS IS PART OF A MULTI-ENTITY HOSPITAL SYSTEM CONTROLLED BY IU HEALTH, A 501(C)(3) TAX-EXEMPT ORGANIZATION WHOSE BOARD IS COMPRISED OF VOTING MEMBERS, OF WHICH SUBSTANTIALLY ALL ARE INDEPENDENT COMMUNITY MEMBERS.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 13 PART VI, LINES 12, 13, 14 AND 16B - POLICIES</FormAndLineReferenceDesc>
        <ExplanationTxt>UNIVERSITY FAMILY PHYSICIANS IS PART OF THE IU HEALTH SYSTEM. AS A MEMBER AND CONTROLLING PARENT OF IU HEALTH PHYSICIANS, A MEMBER AND CONTROLLING PARENT OF UNIVERSITY FAMILY PHYSICIANS, IU HEALTH AND ITS BOARD OF DIRECTORS HAVE MANDATED THAT CERTAIN POLICIES BE FOLLOWED TO ENSURE GREATER STANDARDIZATION THROUGHOUT THE SYSTEM. THUS, UNIVERSITY FAMILY PHYSICIANS' BOARD OF DIRECTORS WAS NOT REQUIRED TO SEPARATELY ADOPT A CONFLICT OF INTEREST, WHISTLEBLOWER, DOCUMENT RETENTION AND DESTRUCTION AND JOINT VENTURE POLICIES BECAUSE IU HEALTH'S BOARD OF DIRECTORS HAD ALREADY ADOPTED AND REQUIRED THESE POLICIES TO BE FOLLOWED BY ITS SUBSIDIARIES.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15 PROCESS FOR DETERMINING COMP</FormAndLineReferenceDesc>
        <ExplanationTxt>UNIVERSITY FAMILY PHYSICIANS' PRESIDENT IS EMPLOYED BY IU HEALTH CARE ASSOCIATES. IU HEALTH CARE ASSOCIATES AND OTHER RELATED ENTITIES HAVE A PROCESS IN PLACE TO DETERMINE THE COMPENSATION FOR ITS OFFICERS AND KEY EMPLOYEES. IU HEALTH HUMAN RESOURCES USES MARKET DATA FROM MULTIPLE COMPENSATION EXPERTS/VENDORS WHO UTILIZE A VARIETY OF METHODS AND PROCEDURES TO OBTAIN COMPENSATION RANGES FOR COMPARABLE OFFICER AND EMPLOYEE POSITIONS. THIS MARKET DATA AND MULTIPLE OTHER FACTORS (INCLUDING MARKET PAY BENCHMARKS, INTERNAL EQUITY, CANDIDATE/EMPLOYEE QUALIFICATIONS &amp; PERFORMANCE, AND BUSINESS NEEDS) ARE USED TO RECOMMEND COMPENSATION RANGES FOR ITS OFFICERS AND OTHER EMPLOYEES, WHICH ARE THEN USED AS A GUIDE FOR SETTING REASONABLE COMPENSATION BY MANAGEMENT.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6 Classes of members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CORPORATION SHALL HAVE TWO (2) MEMBERS. THE CLASS A MEMBER SHALL BE IU HEALTH PHYSICIANS. THE CLASS B MEMBER SHALL BE THE THEN-CURRENT CHAIRMAN OF THE DEPARTMENT OF FAMILY MEDICINE OF THE INDIANA UNIVERSITY SCHOOL OF MEDICINE ("SCHOOL").</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a Members or stockholders electing members of governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CORPORATION SHALL HAVE TWO (2) OR SUCH OTHER NUMBER OF DIRECTORS AS DETERMINED BY THE CLASS A MEMBER. THE DIRECTORS SHALL BE PHYSICIANS WHO ARE MEMBERS OF THE FACULTY OF THE DEPARTMENT OF FAMILY MEDICINE OF THE SCHOOL AND/OR EMPLOYED BY THE CORPORATION AND THE CLASS A MEMBER FOR PERFORMANCE OF PROFESSIONAL SERVICES ON BEHALF OF THE PRIMARY CARE SERVICE LINE.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders</FormAndLineReferenceDesc>
        <ExplanationTxt>NOTWITHSTANDING ANY OTHER PROVISIONS OF THE ARTICLES OF INCORPORATION OR CODE OF BY-LAWS TO THE CONTRARY, THE USE OR EXPENDITURE OF ANY FUNDS EXPRESSLY RESERVED BY THE CORPORATION FOR ITS EDUCATIONAL, TEACHING OR RESEARCH MISSIONS SHALL REQUIRE THE AUTHORIZATION OR APPROVAL OF THE CLASS B MEMBER.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b Review of form 990 by governing body</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PRESIDENT REVIEWED AND APPROVED THE FORM 990 PRIOR TO ITS FILING.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c Conflict of interest policy</FormAndLineReferenceDesc>
        <ExplanationTxt>University Family Physicians FOLLOWS IU HEALTH'S CONFLICT OF INTEREST POLICY. IU HEALTH'S CONFLICT OF INTEREST POLICY INCLUDES THE FOLLOWING PROVISIONS: ALL IU HEALTH EMPLOYEES, ASSOCIATES, COLLEAGUES AND CONTRACTED PERSONNEL, INCLUDING EMPLOYED PHYSICIANS AND PAID MEDICAL DIRECTORS ("IU HEALTH REPRESENTATIVES") ARE COVERED BY AND SUBJECT TO ITS CONFLICT OF INTEREST POLICY. IU HEALTH REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY THROUGH THE FOLLOWING PROCEDURES: (A) ON AN ANNUAL BASIS, EACH IU HEALTH REPRESENTATIVE AT THE LEVEL OF MANAGER OR ABOVE, TOGETHER WITH EVERY OTHER PERSON DESIGNATED BY THE CORPORATE COMPLIANCE DEPARTMENT ("DEPARTMENT"), MUST COMPLETE, SIGN AND SUBMIT A CONFLICT OF INTEREST QUESTIONNAIRE ("QUESTIONNAIRE") TO THE DEPARTMENT. GOVERNING BOARD MEMBERS, COMMITTEE MEMBERS, CORPORATE OFFICERS, MEDICAL STAFF AND RESEARCHERS MUST COMPLY WITH THE ADMINISTRATIVE REQUIREMENTS NOTED IN THE RESPECTIVE POLICIES AND PROCEDURES RELATIVE TO THOSE AREAS. (B) AN IU HEALTH REPRESENTATIVE MUST SUPPLEMENT A QUESTIONNAIRE IN WRITING, IF AFTER COMPLETION OF THE ORIGINAL QUESTIONNAIRE, A SITUATION ARISES, OR MAY REASONABLY BE EXPECTED TO ARISE, THAT WOULD CHANGE ANY ANSWER OR INFORMATION ON THE ORIGINAL QUESTIONNAIRE IF THE SITUATION HAD EXISTED OR BEEN ANTICIPATED AT THE TIME OF COMPLETION OF THE ORIGINAL QUESTIONNAIRE. (C) IF A FULLY AND PROPERLY COMPLETED QUESTIONNAIRE REVEALS FACTS OR OTHER INFORMATION THAT MIGHT REASONABLY INDICATE A CONFLICT OF INTEREST OR VIOLATION OF THE POLICY, THE IU HEALTH REPRESENTATIVE COMPLETING THE QUESTIONNAIRE MUST SECURE APPROVAL BY HIS/HER SUPERVISOR, EVIDENCED IN WRITING. (D) THE DEPARTMENT WILL REVIEW EACH QUESTIONNAIRE AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS AND, IF SO, WHETHER AND HOW IT SHOULD OR MAY BE ELIMINATED, AVOIDED OR MANAGED IN ORDER TO COMPLY WITH THE SPIRIT OF THE POLICY AND WITH THE BEST INTERESTS OF IU HEALTH AND ITS PATIENTS. IN MAKING THE DETERMINATION, THE CORPORATE COMPLIANCE DEPARTMENT MAY CONSULT WITH THE IU HEALTH REPRESENTATIVE'S SUPERVISOR AND OTHER APPROPRIATE INDIVIDUALS AND GROUPS. (E) THE SCOPE OF THE POLICY IS NOT LIMITED TO THOSE WHO ARE REQUIRED TO COMPLETE QUESTIONNAIRES. IF AN IU HEALTH REPRESENTATIVE IS INVOLVED IN A SITUATION OR RELATIONSHIP THAT WOULD CONSTITUTE A VIOLATION OF THE POLICY IN THE ABSENCE OF DISCLOSURE AND APPROVAL AS DESCRIBED ABOVE, THEN THE IU HEALTH REPRESENTATIVE MUST DISCLOSE THE MATTER TO HIS/HER SUPERVISOR, SECURE HIS/HER SUPERVISOR'S APPROVAL IN WRITING, AND DISCLOSE THE MATTER TO THE DEPARTMENT. OTHERWISE, THE IU HEALTH REPRESENTATIVE IS IN VIOLATION OF THE POLICY AND SUBJECT TO CORRECTIVE ACTION, UP TO AND INCLUDING TERMINATION. (F) THE CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH ONSITE COMPLIANCE PERSONNEL, MAY FROM TIME TO TIME APPOINT STANDING OR AD HOC COMMITTEES TO ASSIST IN RESOLVING ISSUES THAT ARISE UNDER PROVISIONS OF THE POLICY.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19 Required documents available to the public</FormAndLineReferenceDesc>
        <ExplanationTxt>UNIVERSITY FAMILY PHYSICIANS' ARTICLES OF INCORPORATION ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE INDIANA SECRETARY OF STATE'S WEBSITE. UNIVERSITY FAMILY PHYSICIANS' CONFLICT OF INTEREST PROCEDURES ARE DISCLOSED ON FORM 990, SCHEDULE O. UNIVERSITY FAMILY PHYSICIANS IS A SUBSIDIARY IN IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS. IU HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH ITS BOND FILINGS AND AS AN ATTACHMENT TO IU HEALTH'S FORM 990.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part IX, Line 11g Other Fees</FormAndLineReferenceDesc>
        <ExplanationTxt>SHARED SERVICES/PROF. FEES - Total Expense: 97821408, Program Service Expense: 97821408, Management and General Expenses: , Fundraising Expenses: ;</ExplanationTxt>
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          <BusinessNameLine1Txt>IU HEALTH BOARD DESIGNATED TRUST</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>IU HEALTH PLANS INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>950 N MERIDIAN ST</AddressLine1Txt>
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          <CityNm>INDIANAPOLIS</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
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        <EIN>262127080</EIN>
        <PrimaryActivitiesTxt>HMO</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>IU HEALTH RISK PURCHASING GROUP INC</BusinessNameLine1Txt>
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          <AddressLine1Txt>151 MEETING ST</AddressLine1Txt>
          <AddressLine2Txt>SUITE 301</AddressLine2Txt>
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        <EIN>260202446</EIN>
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          <BusinessNameLine1Txt>IU HEALTH RISK RETENTION GROUP INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>151 MEETING ST</AddressLine1Txt>
          <AddressLine2Txt>SUITE 301</AddressLine2Txt>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>IUH ASSURANCE SPC LTD</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>PO BOX 69 94 SOLARIS AVE</AddressLine1Txt>
          <AddressLine2Txt>CAMANA BAY</AddressLine2Txt>
          <ProvinceOrStateNm>GRAND CAYMAN</ProvinceOrStateNm>
          <CountryCd>CJ</CountryCd>
        </ForeignAddress>
        <EIN>980395429</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
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          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PROTEUO FUND LP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>PO BOX 69 94 SOLARIS AVE</AddressLine1Txt>
          <AddressLine2Txt>CAMANA BAY</AddressLine2Txt>
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          <CountryCd>CJ</CountryCd>
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        <EIN>981075227</EIN>
        <PrimaryActivitiesTxt>INVESTMENTS</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
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          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
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        <EntityTypeTxt>C Corporation</EntityTypeTxt>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>CERBERUS RESIDENTIAL OPPORT INST LTD</BusinessNameLine1Txt>
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        <ForeignAddress>
          <AddressLine1Txt>190 Elgin Avenue</AddressLine1Txt>
          <AddressLine2Txt>George Town</AddressLine2Txt>
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          <CountryCd>CJ</CountryCd>
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          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>University Surgeons Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>950 N Meridian St Ste 800</AddressLine1Txt>
          <CityNm>Indianapolis</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
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          <AddressLine1Txt>950 N Meridian St Ste 800</AddressLine1Txt>
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          <AddressLine1Txt>950 N Meridian St Ste 800</AddressLine1Txt>
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        <PrimaryActivitiesTxt>Physician Services</PrimaryActivitiesTxt>
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        <DirectControllingEntityName>
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        <RelatedOrganizationName>
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          <AddressLine1Txt>950 N Meridian St Ste 800</AddressLine1Txt>
          <CityNm>Indianapolis</CityNm>
          <StateAbbreviationCd>IN</StateAbbreviationCd>
          <ZIPCd>46204</ZIPCd>
        </USAddress>
        <EIN>351832370</EIN>
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        <LegalDomicileStateCd>IN</LegalDomicileStateCd>
        <DirectControllingEntityName>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
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      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
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      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>false</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
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  </ReturnData>
</Return>