Basic earnings per share are based on the weighted average number of common shares outstanding during the period. Diluted earnings per share are based on the weighted average number of common shares outstanding during the period adjusted to give effect to common stock equivalents.

The following table sets forth the computation of basic and diluted earnings per share for the periods indicated (in thousands, except per share data):


	Three months ended September 30,					Nine months ended September 30,
	2024		2023			2024			2023
Basic and Diluted:
Net income attributable to UHS	$	258,714	$	166,989		$	809,700		$	501,417
Less: Net income attributable to unvested restricted share grants		-		(52	)		(50	)		(242	)
Net income attributable to UHS – basic and diluted	$	258,714	$	166,937		$	809,650		$	501,175

Weighted average number of common shares - basic		66,537		68,867			66,873			69,825
Net effect of dilutive stock options and grants based on the treasury stock method		1,571		757			1,297			825
Weighted average number of common shares and equivalents - diluted		68,108		69,624			68,170			70,650
Earnings per basic share attributable to UHS:	$	3.89	$	2.42		$	12.11		$	7.18
Earnings per diluted share attributable to UHS:	$	3.80	$	2.40		$	11.88		$	7.09

The “Net effect of dilutive stock options and grants based on the treasury stock method”, for all periods presented above, excludes certain outstanding stock options applicable to each period since the effect would have been anti-dilutive. There were no excluded weighted-average stock options for the three-months ended September 30, 2024 and 799,000 for the nine-months ended September 30, 2024. The excluded weighted-average stock options totaled 5.0 million for the three months ended September 30, 2023 and 5.1 million for the nine months ended September 30, 2023. All classes of our common stock have the same dividend rights.

During the three-month periods ended September 30, 2024 and 2023, pre-tax compensation costs of $13.4 million and $16.2 million, respectively, was recognized related to outstanding stock options. During the nine-month periods ended September 30, 2024 and 2023, pre-tax compensation costs of $41.0 million and $48.3 million, respectively, was recognized related to outstanding stock options. In addition, during the three-month periods ended September 30, 2024 and 2023, pre-tax compensation cost of approximately $12.9 million and $6.1 million, respectively, was recognized related to restricted stock awards, restricted stock units and performance based restricted stock units. During the nine-month periods ended September 30, 2024 and 2023, pre-tax compensation costs of approximately $30.7 million and $16.4 million, respectively, was recognized related to restricted stock awards, restricted stock units and performance based restricted stock units. As of September 30, 2024 there was approximately $177.9 million of unrecognized compensation cost related to unvested options, restricted stock awards, restricted stock units and performance based restricted stock units which is expected to be recognized over the remaining weighted average vesting period of 2.5 years. There were 3,000 stock options granted during the first nine months of 2024 under the 2020 Stock Incentive Plan with a weighted-average grant date fair value of $44.58 per option. There were an aggregate of 501,290 restricted units, net of cancellations, granted during the first nine months of 2024 under the 2020 Stock Incentive Plan, including 63,362 performance based restricted stock units, with a weighted-average grant date fair value of $181.05 per share.

The expense associated with stock-based compensation arrangements is a non-cash charge. In the condensed consolidated statements of cash flows, stock-based compensation expense is an adjustment to reconcile net income to cash provided by operating activities and aggregated to $72.7 million and $65.7 million during the nine-month periods ended September 30, 2024 and 2023, respectively.