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      <TotRevenueEtcAuditedFinclStmt>6700973</TotRevenueEtcAuditedFinclStmt>
      <RevenueSubtotal>6700973</RevenueSubtotal>
      <TotalRevenuePerForm990>6700973</TotalRevenuePerForm990>
      <TotExpensesEtcAuditedFinclStmt>7540836</TotExpensesEtcAuditedFinclStmt>
      <ExpensesSubtotal>7540836</ExpensesSubtotal>
      <TotalExpensesPerForm990>7540836</TotalExpensesPerForm990>
      <Form990ScheduleDPartXIII>
        <Identifier>LIABILITY UNDER FIN 48 FOOTNOTE</Identifier>
        <ReturnReference>SCHEDULE D, PAGE 3, PART X</ReturnReference>
        <Explanation>INSTITUTE FOR CLINICAL RESEARCH, INC. HAS ADOPTED THE PROVISIONS OF FASB ASC 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. ASC 740 REQUIRES THAT A TAX POSITION BE RECOGNIZED ON A 'MORE-LIKELY-THAN-NOT' THRESHOLD. THIS APPLIES TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE IMPLEMENTATION OF ACS 740 HAD NO IMPACT ON INSTITUTE FOR CLINICAL RESEARCH, INC.'S AUDITED STATEMENT OF ASSETS, LIABILITIES, AND NET ASSETS OR STATEMENT OF SUPPORT, REVENUES, AND EXPENSES. INSTITUTE FOR CLINICAL RESEARCH, INC. DOES NOT BELIEVE THEIR FINANCIAL STATEMENTS INCLUDE (OR REFLECT) ANY UNCERTAIN TAX POSITIONS.</Explanation>
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    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="RetDoc5">
      <GeneralExplanation>
        <Identifier>ORGANIZATION'S PROCESS USED TO REVIEW FORM 990</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 11B</ReturnReference>
        <Explanation>THE 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND THE OPERATIONS MANAGER PRIOR TO SUBMISSION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ENFORCEMENT OF CONFLICTS POLICY</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 12C</ReturnReference>
        <Explanation>ALL MEMBERS OF THE BOARD OF DIRECTORS, INVESTIGATORS, OFFICERS AND EMPLOYEES OF INSTITUTE FOR CLINICAL RESEARCH CERTIFY ANNUALLY THAT THEY ARE AWARE OF AND IN COMPLIANCE WITH FEDERAL CONDUCT AND CONFLICTS OF INTEREST LAWS AND REGULATIONS. THE EXECUTIVE DIRECTOR REVIEWS THE STATEMENTS AND CERTIFIES ANNUALLY THAT A STATEMENT IS ON THEIR FILE. SHOULD A POTENTIAL OR ACTUAL CONFLICT IS IDENTIFIED DURING SUCH REVIEW INSTITUTE FOR CLINICAL RESEARCH WILL PURSUE THIS MATTER IN ACCORDANCE WITH VA RULES AND REGULATIONS, INCLUDING SEEKING ASSISTANCE FROM VA LEGAL COUNSEL, AS NEEDED, AND PROHIBITING THE PERSON WITH IDENTIFIED CONFLICT FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTIONS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION PROCESS FOR TOP OFFICIAL</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 15A</ReturnReference>
        <Explanation>INDEPENDENT BOARD REVIEWS AND APPROVES COMPENSATION OF THE EXECUTIVE DIRECTOR AND KEY EMPLOYEES.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION PROCESS FOR OFFICERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 15B</ReturnReference>
        <Explanation>INDEPENDENT BOARD REVIEWS AND APPROVES COMPENSATION OF THE EXECUTIVE DIRECTOR AND KEY EMPLOYEES.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>GOVERNING DOCUMENTS DISCLOSURE EXPLANATION</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 19</ReturnReference>
        <Explanation>THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER FEES FOR SERVICES</Identifier>
        <ReturnReference>FORM 990, PART IX, LINE 11G</ReturnReference>
        <Explanation>INTERAGENCY AGREEMENT IPA/VA 928,871 0 0 PAYROLL PROCESSING FEE 0 4,611 0 SPEAKER HONORARIUM 2,500 0 0 CONSULTANTS 7,060 0 0 SUBCONTRACTS 1,480,399 0 0 OTHER 65,215 0 0</Explanation>
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</Return>