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        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
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        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY ISLAND PEER REVIEW ORGANIZATION'S BOARD OF DIRECTORS. THE BOARD REGULARLY USES EXTERNAL DATA FOR COMPARISONS AND CONTRACT. MEMBERS OF THE BOARD ARE INFORMED OF SALARY INCREASE RECOMMENDATIONS, WHICH THEY REVIEW, DISCUSS, AND APPROVE THE SALARY INCREASES. CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATIONS AND DECISIONS ARE MAINTAINED.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>EXECUTIVE VICE PRESIDENT, THEODORE O. WILL, DIRECTOR, HARRY FEDER, DIRECTOR, CLARE BRADLEY POLLET, AND DIRECTOR, ALAN WOGHIN, ARE EMPLOYEES OF A RELATED ORGANIZATION, ISLAND PEER REVIEW ORGANIZATION, INC. (IPRO) THROUGH WHICH THEY PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE AMOUNTS CONTRIBUTED BY IPRO ON THEIR BEHALF IN CALENDAR YEAR 2023 ARE: THEODORE O. WILL: $20,800; CLAIRE BRADLEY POLLET: $17,517, ALAN WOGHIN: $23,400. THESE AMOUNTS ARE INCLUDED IN THE AMOUNTS REPORTED IN COLUMN (C). THE AMOUNT OF DISTRIBUTION RECEIVED FROM THE NONQUALIFIED RETIREMENT PLAN IN CALENDAR YEAR 2023 IS: THEODORE O. WILL: $15,946; HARRY FEDER: $20,701. THESE AMOUNTS ARE INCLUDED IN THE AMOUNTS REPORTED IN COLUMN (B)(III).</ExplanationTxt>
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        <ExplanationTxt>THE REPORTING ORGANIZATION HAS ADOPTED THE WHISTLEBLOWER AND DOCUMENT RETENTION AND DESTRUCTION POLICIES OF ITS SOLE MEMBER, ISLAND PEER REVIEW ORGANIZATION, INC.</ExplanationTxt>
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        <ExplanationTxt>ISLAND PEER REVIEW ORGANIZATION, INC. ("IPRO") IS THE SOLE MEMBER OF LUMETRA HEALTHCARE SOLUTIONS.</ExplanationTxt>
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        <ExplanationTxt>AS THE SOLE MEMBER OF LUMETRA HEALTHCARE SOLUTIONS, IPRO HAS THE AUTHORITY TO ELECT THE BOARD OF DIRECTORS.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM. THE CFO, VP - OPERATIONS AND EXECUTIVE DIRECTOR REVIEWS THE FORM 990 BEFORE SENDING THE RETURN TO THE FINANCE COMMITTEE FOR REVIEW. THE FINAL FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE AND THEN DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION CURRENTLY HAS IN PLACE A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL OFFICERS, DIRECTORS, AND OTHER KEY PERSONS, WHICH IT ANNUALLY MONITORS AND ENFORCES. THE BOARD MANDATES THAT ALL KEY PERSONS COMPLETE A FINANCIAL DISCLOSURE FORM ANNUALLY AND DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS THAT MAY EXIST. THE COMPLETED FINANCIAL DISCLOSURE FORM MUST BE SUBMITTED TO THE SECRETARY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD MEETING TO ANSWER ANY QUESTIONS, BUT AFTER THE PRESENTATION, HE/SHE MUST LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. THE REMAINING BOARD MEMBERS MUST DECIDE IF A CONFLICT OF INTEREST EXISTS. THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD DELEGATED POWERS MUST CONTAIN: (I) THE TERMS APPROVED, (II) THE NAMES OF THOSE INDIVIDUALS WHO PARTICIPATED IN THE DISCUSSION AND VOTE ON THE TRANSACTION, (III) THE NAMES OF ANY INDIVIDUALS WHO WERE RECUSED FROM THE DISCUSSION AND VOTE, (IV) THE COMPARABILITY DATA OBTAINED AND RELIED UPON, (V) IF THE APPROVED TERMS DIFFER MATERIALLY FROM THOSE OF THE OBTAINED COMPARABILITY DATA, AN EXPLANATION OF THE BOARD OR AUTHORIZED BOARD COMMITTEE'S DETERMINATION THAT THE TRANSACTION WAS NEVERTHELESS APPROPRIATE, AND (VI) CONSIDERATION OF ANY ALTERNATIVE TRANSACTIONS.</ExplanationTxt>
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        <ExplanationTxt>THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS ALSO AVAILABLE ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES.</ExplanationTxt>
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        <ExplanationTxt>PAYROLL SERVICE FEES 4,368. PHYSICIAN ADVISORS 299,416.</ExplanationTxt>
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        <ExplanationTxt>THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR.</ExplanationTxt>
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