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        <ExplanationTxt>THOMAS A. OWENS, MD AND ROBERT N. WILLIS SERVED AS OFFICERS OF DUKE UNIVERSITY HEALTH SYSTEM, INC. LISA M. GOODLETT, MARY PAT DUNCAN, LORNA MAXWELL AND DONNA PETER WERE EMPLOYEES OF DUKE UNIVERSITY HEALTH SYSTEM, INC. THOMAS A. OWENS, MD, ROBERT N. WILLIS, MARY PAT DUNCAN AND DONNA PETER SERVED AS DIRECTORS AND OFFICERS OF HEALTH SYSTEM MEDICAL STRATEGIES, INC. THOMAS A. OWENS, MD, LISA M. GOODLETT AND ROBERT N. WILLIS SERVED AS DIRECTORS AND OFFICERS OF DURHAM CASUALTY COMPANY, LTD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>APPOINTMENT TO THE BOARD OF DIRECTORS OF DUKE AFFILIATIONS NETWORK, INC. IS CONTROLLED BY DUKE UNIVERSITY HEALTH SYSTEM, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ANNUAL BUDGET FOR DUKE AFFILIATIONS NETWORK, INC. IS APPROVED BY DUKE UNIVERSITY HEALTH SYSTEM, INC. MANAGEMENT AND BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>AFTER STAFF PREPARATION AND MANAGEMENT REVIEW, DUKE AFFILIATIONS NETWORK, INC. FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW AND COMMENT. BOARD LEVEL COMMENT AND DISCUSSION ARE INCORPORATED INTO THE FORM AS APPROPRIATE PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>DUKE AFFILIATIONS NETWORK, INC. MONITORS AND ENFORCES COMPLIANCE RELATED TO CONFLICT OF INTEREST VIA DUKE AFFILIATIONS NETWORK, INC.'S FORM 990 CONFLICT OF INTEREST QUESTIONNAIRE. THIS QUESTIONNAIRE IS COMPLETED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 16B: DUKE AFFILIATIONS NETWORK, INC. FOLLOWS A WRITTEN POLICY THAT REQUIRES DUKE AFFILIATIONS NETWORK, INC. TO EVALUATE ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS AND NEGOTIATE TERMS AND SAFEGUARDS TO PROTECT THE ORGANIZATION'S ASSETS AND EXEMPT STATUS. DUKE AFFILIATIONS NETWORK, INC. PUTS TERMS AND SAFEGUARDS IN AGREEMENTS WITH THIRD PARTIES TO PROTECT THE ASSETS AND EXEMPT STATUS OF THE ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 18</FormAndLineReferenceDesc>
        <ExplanationTxt>IN ADDITION TO PROVIDING THE ORGANIZATION'S FORM 990 UPON REQUEST, THE ORGANIZATION'S FORM 990 IS AVAILABLE TO THE PUBLIC ON SEVERAL THIRD PARTY WEBSITES. WHILE THE ORGANIZATION DOES NOT PROVIDE THE FORM 990 DIRECTLY TO THESE THIRD PARTIES, THE FORM 990 IS OBTAINED FROM THE INTERNAL REVENUE SERVICE. THE THIRD PARTIES SUBSEQUENTLY AND INDEPENDENTLY PROVIDE ACCESS TO THE FORM 990 ON THEIR PLATFORM.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>DUKE AFFILIATIONS NETWORK, INC. GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND ANY SUBSEQUENT AMENDMENTS OR RESTATEMENTS) ARE AVAILABLE TO THE PUBLIC ON THE NORTH CAROLINA SECRETARY OF STATE WEBSITE. DUKE AFFILIATIONS NETWORK, INC. IS INCLUDED IN CONSOLIDATED, INDEPENDENTLY AUDITED FINANCIAL STATEMENTS OF DUHS WHICH ARE AVAILABLE AT HTTPS://CORPORATE.DUKEHEALTH.ORG/FINANCIAL-INFORMATION</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONTRACT WORK: PROGRAM SERVICE EXPENSES 50,208. MANAGEMENT AND GENERAL EXPENSES 628,114. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 678,322. BILLING &amp; COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 150,039. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 150,039.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>INTERCOMPANY TRANSFER BETWEEN DAN, INC. AND DUHS, INC. 10,744.</ExplanationTxt>
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          <BusinessNameLine1Txt>RALLYDAY LF CO-INVESTORS LP</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>DUKE CE LS INC</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>DUKE CE (SEA) PRIVATE LIMITED</BusinessNameLine1Txt>
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          <AddressLine1Txt>1 RAFFLES PLACE TOWER 2</AddressLine1Txt>
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          <BusinessNameLine1Txt>DUKE CORP EDU INDIA PRIVATE</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>DUKE CORPORATE EDUCATION LIM</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>DUKE CORPORATE EDUCATION RSA</BusinessNameLine1Txt>
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          <AddressLine1Txt>GROUND FLOOR TWICKEHNHAM BLDG</AddressLine1Txt>
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          <BusinessNameLine1Txt>DUKE GLOBAL CONSULTING (KUNSHAN)</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>MARATHON BLUE CAYMAN FUND</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>GHI HOLDINGS MAURITIUS</BusinessNameLine1Txt>
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          <AddressLine1Txt>9TH FL ORANGE TOWER CYBERCITY</AddressLine1Txt>
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      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MCP PRIVATE CAPITAL (FEEDER) FUND I LP</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>6 RUE GABRIEL LIPPMANN</AddressLine1Txt>
          <CityNm>LUXEMBOURG</CityNm>
          <CountryCd>LU</CountryCd>
          <ForeignPostalCd>L-5365</ForeignPostalCd>
        </ForeignAddress>
        <PrimaryActivitiesTxt>INVESTMENTS</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>LU</LegalDomicileForeignCountryCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>DUKE INDIA SERVICES PRIVATE LIMITED</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>302 PRIDE ELITE 10 MUSEUM ROAD</AddressLine1Txt>
          <CityNm>BANGALORE</CityNm>
          <ProvinceOrStateNm>KARNATAKA</ProvinceOrStateNm>
          <CountryCd>IN</CountryCd>
          <ForeignPostalCd>560001</ForeignPostalCd>
        </ForeignAddress>
        <PrimaryActivitiesTxt>MEDICAL RESEARCH</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>IN</LegalDomicileForeignCountryCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>HEALTH SYSTEM MEDICAL STRATEGIES INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>2200 W MAIN STREET STE 300</AddressLine1Txt>
          <CityNm>DURHAM</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27705</ZIPCd>
        </USAddress>
        <EIN>562222444</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>DUKE GLOBAL GERMANY GMBH</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>ESCHERSHEIMER LANDSTR 14</AddressLine1Txt>
          <CityNm>FRANKFURT</CityNm>
          <CountryCd>GM</CountryCd>
          <ForeignPostalCd>60322</ForeignPostalCd>
        </ForeignAddress>
        <PrimaryActivitiesTxt>EDUCATION</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>GM</LegalDomicileForeignCountryCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MEDBLUE INCUBATOR INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>410 MARTIN LUTHER KING BLVD</AddressLine1Txt>
          <CityNm>CHAPEL HILL</CityNm>
          <StateAbbreviationCd>NC</StateAbbreviationCd>
          <ZIPCd>27514</ZIPCd>
        </USAddress>
        <EIN>463181380</EIN>
        <PrimaryActivitiesTxt>CONSULTING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DE</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>